MEDICARE: MR. KHALID MOHAMMED AHMED MD

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	4301062460	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	OB5110	OTHER	MI	CENTRAL STATES HEALTH & W
2	1062460	OTHER	MI	GENESEE HEALTH PLAN
3	139149	OTHER	MI	CARE CHOICES
4	1001610	OTHER	MI	MCLAREN HEALTH PLAN
5	1001610	OTHER	MI	MCLAREN HEALTH ADVANTAGE
6	1062460	OTHER	MI	HEALTHPLUS
7	1062460	OTHER	MI	HEALTHPLUS PARTNERS
8	383520014050	OTHER	MI	COMMUNITY CHOICE OF MICHI
9	7804582	OTHER	MI	AETNA
10	C4302	OTHER		MCARE
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	4831	OTHER	MI	TOTAL HEALTH CARE

General Provider Information

NPI Number	:	1619965175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KHALID MOHAMMED AHMED MD

Provider Business Mailing Address
First Line	:	2700 ROBERT T LONGWAY BLVD
Second Line	:	SUITE B
City	:	FLINT
State	:	MI
Zip	:	48503-2190
Country	:	US
Telephone Number	:	810-235-2004
Fax Number	:	810-235-2841

Provider Business Practice Location Address
First Line	:	2700 ROBERT T LONGWAY BLVD
Second Line	:	SUITE B
City	:	FLINT
State	:	MI
Zip	:	48503-2190
Country	:	US
Telephone Number	:	810-235-2004
Fax Number	:	810-235-2841

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

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	07/08/2007

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Directions to “ MR. KHALID MOHAMMED AHMED MD” Practice Location

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