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General NPI Number Information
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NPI Number | 1982906392
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Entity Type | Organization
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Legal Business Name | KHADIJA AHMED MD LLC
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Dates
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Enumeration Date | 11/18/2010
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Last Update Date | 01/12/2011
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Provider Practice Location Address
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Address Line | 2131 N LIMESTONE ST
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City | SPRINGFIELD
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State | OH
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Zip | 45503-2676
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Country | US
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Telephone | 937-342-9160
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Fax | 937-342-9159
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Provider Business Mailing Address
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Address Line | 2131 N LIMESTONE ST
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City | SPRINGFIELD
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State | OH
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Zip | 45503-2676
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Country | US
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Telephone | 937-342-9160
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Fax | 937-342-9159
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Authorized Official
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Title or Position | OWNER
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Name | KHADIJA L AHMED
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Credential | M.D.
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Telephone | 937-342-9160
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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 | 35-094335
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License Number State | OH
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