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General NPI Number Information
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NPI Number | 1366595324
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Entity Type | Individual
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Provider Name | MUDASSAR AHMED MBBS
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Gender | Male
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Dates
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Enumeration Date | 01/20/2007
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 200 S ENOTA DR NE STE 200
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City | GAINESVILLE
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State | GA
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Zip | 30501-3466
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Country | US
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Telephone | 770-534-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 201 S 11TH ST UNIT 1530
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City | MINNEAPOLIS
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State | MN
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Zip | 55403-2765
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Country | US
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Telephone |
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 17514
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 17514
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 105154
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License Number State | GA
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