MEDICARE: SHAHEDA R 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	35034058	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000192606	OTHER	OH	ANTHEM
2	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	:	1851399315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAHEDA R AHMED MD

Provider Business Mailing Address
First Line	:	5620 SOUTHWYCK BLVD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-1501
Country	:	US
Telephone Number	:	419-866-1804
Fax Number	:

Provider Business Practice Location Address
First Line	:	2222 CHERRY ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43608-2673
Country	:	US
Telephone Number	:	419-251-4534
Fax Number	:

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

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	01/15/2008

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