MEDICARE: DR. AHMAD I ISSA 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	207R00000X	Internal Medicine Physician	ME120546	FL
2	208M00000X	Hospitalist Physician	ME120546	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01384022	OTHER	FL	MEDICARE RAILROAD PROVIDER NUMBER

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689946212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AHMAD I ISSA M.D.

Provider Business Mailing Address
First Line	:	2262 NORWOOD OAKS DR
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29466-7027
Country	:	US
Telephone Number	:	813-751-5055
Fax Number	:

Provider Business Practice Location Address
First Line	:	1952 LONG GROVE DR STE 2
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-7579
Country	:	US
Telephone Number	:	854-800-2377
Fax Number	:

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

Provider Enumeration Date	:	01/27/2012
Last Update Date	:	05/15/2025

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Directions to “ DR. AHMAD I ISSA M.D.” Practice Location

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