MEDICARE: DR. IRFAN AHSAN 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	208M00000X	Hospitalist Physician	2021024980	MO
2	208M00000X	Hospitalist Physician	MD461260	PA

General Provider Information

NPI Number	:	1871904862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IRFAN AHSAN M.D

Provider Business Mailing Address
First Line	:	925 CHESTNUT ST STE 200
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4215
Country	:	US
Telephone Number	:	215-955-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	925 CHESTNUT ST STE 200
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4215
Country	:	US
Telephone Number	:	215-955-6000
Fax Number	:

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

Provider Enumeration Date	:	05/13/2014
Last Update Date	:	10/14/2022

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