MEDICARE: MAHBUB 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	213709	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G300000327	OTHER	NY	MEDICARE NGS(QUEENS)

Other Identifiers

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

General Provider Information

NPI Number	:	1689732257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAHBUB AHMED MD

Provider Business Mailing Address
First Line	:	518 MCDONALD AVE
Second Line	:	SUITE 1
City	:	BROOKLYN
State	:	NY
Zip	:	11218-3870
Country	:	US
Telephone Number	:	917-652-4627
Fax Number	:	917-652-4629

Provider Business Practice Location Address
First Line	:	518 MCDONALD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-3870
Country	:	US
Telephone Number	:	917-652-4627
Fax Number	:	917-652-4629

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

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	12/08/2014

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