MEDICARE: AHAMMED HASHIM M.D.

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	207RP1001X	Pulmonary Disease Physician	N2558	TX

General Provider Information

NPI Number	:	1235134420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHAMMED HASHIM M.D.

Provider Business Mailing Address
First Line	:	PO BOX 631310
Second Line	:
City	:	NACOGDOCHES
State	:	TX
Zip	:	75963-1310
Country	:	US
Telephone Number	:	936-585-4646
Fax Number	:

Provider Business Practice Location Address
First Line	:	1209 N MOUND ST
Second Line	:
City	:	NACOGDOCHES
State	:	TX
Zip	:	75961-4028
Country	:	US
Telephone Number	:	936-585-4646
Fax Number	:

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

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	09/12/2011

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