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General NPI Number Information
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NPI Number | 1245842699
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Entity Type | Individual
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Provider Name | ATTILA AHMAD MD
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Gender | Male
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Dates
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Enumeration Date | 08/18/2020
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 1465 S GRAND BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63104-1003
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Country | US
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Telephone | 314-617-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 1468 BRIARWOOD RD NE UNIT 2005
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City | BROOKHAVEN
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State | GA
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Zip | 30319-5746
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Country | US
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Telephone | 573-424-9134
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 85807
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 56582
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 2024005523
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License Number State | MO
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