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General NPI Number Information
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NPI Number | 1346209996
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Entity Type | Organization
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Legal Business Name | MUSHTAQUE AHMED MD PSC
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 03/20/2008
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Provider Practice Location Address
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Address Line | 1101 SAINT CHRISTOPHER DR SUITE 300
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City | ASHLAND
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State | KY
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Zip | 41101-7087
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Country | US
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Telephone | 606-834-1188
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Fax | 606-834-8828
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Provider Business Mailing Address
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Address Line | PO BOX 1930
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City | ASHLAND
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State | KY
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Zip | 41105-1930
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Country | US
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Telephone | 606-329-9414
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Fax | 606-327-1776
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Authorized Official
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Title or Position | PRESIDENT
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Name | MUSHTAQUE AHMED
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Credential | MD
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Telephone | 606-834-1188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 31740
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License Number State | KY
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