MEDICARE: MR. IJAZ AHMAD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	12398	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023093325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. IJAZ AHMAD MD

Provider Business Mailing Address
First Line	:	2828 FIRST AVE SUITE 202
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25702-1236
Country	:	US
Telephone Number	:	304-522-1299
Fax Number	:	304-522-2954

Provider Business Practice Location Address
First Line	:	2828 FIRST AVE SUITE 202
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25702-1236
Country	:	US
Telephone Number	:	304-522-1299
Fax Number	:	304-522-2954

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	02/08/2008

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Directions to “ MR. IJAZ AHMAD MD” Practice Location

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