=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275559445
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YASMEEN GHIAS AHMED MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/14/2006
-----------------------------------------------------
Last Update Date | 05/14/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7001 JOHNNYCAKE RD SUITE 106
-----------------------------------------------------
City | WINDSOR MILL
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21244-2418
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-744-8111
-----------------------------------------------------
Fax | 410-744-8110
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2570 DONLENIK
-----------------------------------------------------
City | YORK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17402-8256
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-755-9459
-----------------------------------------------------
Fax | 717-851-1569
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | MD062858L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | D0061865
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------