MEDICARE: HAMZA FAHMI AHMED

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	106S00000X	Behavior Technician
2	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1285526590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAMZA FAHMI AHMED

Provider Business Mailing Address
First Line	:	5025 MULCARE DR
Second Line	:
City	:	COLUMBIA HEIGHTS
State	:	MN
Zip	:	55421-1836
Country	:	US
Telephone Number	:	763-614-4716
Fax Number	:

Provider Business Practice Location Address
First Line	:	5025 MULCARE DR
Second Line	:
City	:	COLUMBIA HEIGHTS
State	:	MN
Zip	:	55421-1836
Country	:	US
Telephone Number	:	763-614-4716
Fax Number	:

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

Provider Enumeration Date	:	07/21/2025
Last Update Date	:	07/21/2025

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