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General NPI Number Information
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NPI Number | 1447799754
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Entity Type | Individual
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Provider Name | RUKAN AHMED STUDENT
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Gender | Male
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Dates
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Enumeration Date | 02/20/2017
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 2300 N LIMESTONE ST STE 120
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City | SPRINGFIELD
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State | OH
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Zip | 45503-1102
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Country | US
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Telephone | 937-504-8390
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Fax |
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Provider Business Mailing Address
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Address Line | 2967 BROOKMONT CT
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City | HILLIARD
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State | OH
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Zip | 43026-7938
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Country | US
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Telephone | 937-474-0283
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34.015486
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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