MEDICARE: AMMARA AFZAL MBBS

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	35.149080	OH

General Provider Information

NPI Number	:	1114548088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMMARA AFZAL MBBS

Provider Business Mailing Address
First Line	:	3145 HAMILTON MASON RD STE 300
Second Line	:
City	:	FAIRFIELD TOWNSHIP
State	:	OH
Zip	:	45011-8556
Country	:	US
Telephone Number	:	513-863-6222
Fax Number	:	513-863-6478

Provider Business Practice Location Address
First Line	:	3145 HAMILTON MASON RD STE 300
Second Line	:
City	:	FAIRFIELD TOWNSHIP
State	:	OH
Zip	:	45011-8556
Country	:	US
Telephone Number	:	513-863-6222
Fax Number	:	513-863-6478

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

Provider Enumeration Date	:	05/02/2020
Last Update Date	:	12/18/2023

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