MEDICARE: APPAS 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	172A00000X	Driver	57791	IN

General Provider Information

NPI Number	:	1558576637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	APPAS AHMED

Provider Business Mailing Address
First Line	:	PO BOX 532588
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46253-2588
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1152 N WHITCOMB AVE
Second Line	:	APT (C)
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46224-6714
Country	:	US
Telephone Number	:	317-294-5005
Fax Number	:	760-268-2236

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

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	07/08/2007

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