MEDICARE: AHMED GHALEB 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	207L00000X	Anesthesiology Physician	E-3215	AR
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	E-3215	AR
3	208VP0014X	Interventional Pain Medicine Physician	E-3215	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	050086527	OTHER	AR	RAILROAD MEDICARE
3	P00020406	OTHER	AR	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1104916675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHMED GHALEB MD

Provider Business Mailing Address
First Line	:	11220 EXECUTIVE CENTER DR STE 200
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72211-4492
Country	:	US
Telephone Number	:	501-219-1114
Fax Number	:	501-219-1115

Provider Business Practice Location Address
First Line	:	11220 EXECUTIVE CENTER DR STE 200
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72211-4492
Country	:	US
Telephone Number	:	501-219-1114
Fax Number	:	501-219-1115

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

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	04/11/2024

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Directions to “ AHMED GHALEB MD” Practice Location

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