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General NPI Number Information
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NPI Number | 1154588317
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Entity Type | Organization
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Legal Business Name | ANIS AHMAD, M.D., S.C.
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Dates
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Enumeration Date | 05/16/2008
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Last Update Date | 03/25/2010
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Provider Practice Location Address
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Address Line | 3061 7TH ST STE A
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City | MOLINE
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State | IL
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Zip | 61265-5903
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Country | US
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Telephone | 309-762-6161
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Fax | 309-762-5387
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Provider Business Mailing Address
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Address Line | 3061 7TH ST STE A
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City | MOLINE
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State | IL
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Zip | 61265-5903
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Country | US
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Telephone | 309-762-6161
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Fax | 309-762-5387
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Authorized Official
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Title or Position | M.D
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Name | ANIS AHMAD
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Credential | M.D., F.R.C.P.
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Telephone | 309-762-6161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 036049910
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036049910
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License Number State | IL
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