MEDICARE: BASEM B. AHMED 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	946513	KS

General Provider Information

NPI Number	:	1609908821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BASEM B. AHMED M.D.

Provider Business Mailing Address
First Line	:	10819 NOLAND CT
Second Line	:
City	:	LENEXA
State	:	KS
Zip	:	66210-3739
Country	:	US
Telephone Number	:	913-469-0048
Fax Number	:

Provider Business Practice Location Address
First Line	:	UNIVERSITY OF KANSAS MEDICAL CTR 3901 RAINBOW BLVD
Second Line	:	2017 WAHL HALL WEST MS 3045
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-0001
Country	:	US
Telephone Number	:	913-588-7070
Fax Number	:	913-588-7076

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

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	07/08/2007

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