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General NPI Number Information
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NPI Number | 1841477197
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Entity Type | Organization
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Legal Business Name | NOOR AHMED, M.D., P.C.
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Dates
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Enumeration Date | 01/29/2008
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Last Update Date | 01/29/2008
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Provider Practice Location Address
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Address Line | 2 MEMORIAL DR SUITE 104
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City | ALTON
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State | IL
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Zip | 62002-6723
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Country | US
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Telephone | 618-465-6401
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Fax | 618-465-0411
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Provider Business Mailing Address
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Address Line | 2 MEMORIAL DR SUITE 104
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City | ALTON
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State | IL
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Zip | 62002-6723
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Country | US
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Telephone | 618-465-6401
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Fax | 618-465-0411
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. NOOR AHMED
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Credential | M.D.
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Telephone | 618-465-6401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | IL
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