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1053536219

NPI Code Detail

MEDICARE: IMDAD AHMED MD

MEDICARE: IMDAD AHMED 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	207R00000X	Internal Medicine Physician	036140036	IL
2	207RC0001X	Clinical Cardiac Electrophysiology Physician	65353-20	WI
3	207RC0000X	Cardiovascular Disease Physician	036140036	IL
4	207RC0001X	Clinical Cardiac Electrophysiology Physician	052275	CT
5	207RC0001X	Clinical Cardiac Electrophysiology Physician	036-140036	IL
6	207RC0000X	Cardiovascular Disease Physician	052275	CT
7	207R00000X	Internal Medicine Physician	102950	MN
8	207RC0000X	Cardiovascular Disease Physician	MT198590	PA

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

General Provider Information

NPI Number	:	1053536219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IMDAD AHMED MD

Provider Business Mailing Address
First Line	:	1000 MINERAL POINT AVE
Second Line	:
City	:	JANESVILLE
State	:	WI
Zip	:	53548-2940
Country	:	US
Telephone Number	:	608-756-6868
Fax Number	:	608-756-6289

Provider Business Practice Location Address
First Line	:	1000 MINERAL POINT AVE
Second Line	:
City	:	JANESVILLE
State	:	WI
Zip	:	53548-2940
Country	:	US
Telephone Number	:	608-756-6868
Fax Number	:	608-756-6289

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

Provider Enumeration Date	:	04/14/2007
Last Update Date	:	03/31/2026

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Directions to “ IMDAD AHMED MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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