MEDICARE: DR. USMA SHAHEEN AHMAD MD 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	207R00000X	Internal Medicine Physician	233424	MA
2	207R00000X	Internal Medicine Physician	44841	AZ

Other Identifiers

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

General Provider Information

NPI Number	:	1588824098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. USMA SHAHEEN AHMAD MD MBBS

Provider Business Mailing Address
First Line	:	1134 E UNIVERSITY DR STE 111
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85203-8048
Country	:	US
Telephone Number	:	480-398-1220
Fax Number	:	480-398-1230

Provider Business Practice Location Address
First Line	:	1134 E UNIVERSITY DR STE 111
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85203-8048
Country	:	US
Telephone Number	:	480-398-1220
Fax Number	:	480-398-1230

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

Provider Enumeration Date	:	06/10/2008
Last Update Date	:	11/05/2018

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