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NPI Code Detail

MEDICARE: AHMED K AGHA M.D., PHARMD

MEDICARE: AHMED K AGHA M.D., PHARMD
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
1207Q00000XFamily Medicine Physician58031AZ
2183500000XPharmacist03-2-22901OH

General Provider Information

NPI Number : 1063413524
Entity Type Code : Individual
Provider Name (Legal Business Name) : AHMED K AGHA M.D., PHARMD
Provider Business Mailing Address
First Line : 3124 WILLOW CREEK RD
Second Line :
City : PRESCOTT
State : AZ
Zip : 86301-6610
Country : US
Telephone Number : 928-445-7085
Fax Number : 928-445-7095
Provider Business Practice Location Address
First Line : 2000 W BETHANY HOME RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-2443
Country : US
Telephone Number : 602-246-5658
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 01/30/2020

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