1881615516 NPI number — ARIF AHMAD MD

Table of content: ARIF AHMAD MD (NPI 1881615516)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881615516 NPI number — ARIF AHMAD MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AHMAD
Provider First Name:
ARIF
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881615516
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/16/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
515 22ND AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONROE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53566-1569
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
608-324-2000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
515 22ND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONROE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53566-1569
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
608-324-2000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  38449 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2000646 . This is a "PHYSICIANS PLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 32621700 . This is a "HIRSP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 390808509DS . This is a "UNITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 390808509 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 32765806901 . This is a "BC/BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 14096 . This is a "DEAN HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 32765806 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 32621700 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 32765806 . This is a "ILLINOIS PUBLIC AID" identifier . This identifiers is of the category "OTHER".




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