1356324115 NPI number — ISMAIL SULEMAN AHMED MD

Table of content: ISMAIL SULEMAN AHMED MD (NPI 1356324115)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356324115 NPI number — ISMAIL SULEMAN AHMED MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AHMED
Provider First Name:
ISMAIL
Provider Middle Name:
SULEMAN
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:
1356324115
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 636643
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45263-6643
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-989-3801
Provider Business Mailing Address Fax Number:
440-960-0264

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1120 E BROAD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELYRIA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44035-6306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-366-2239
Provider Business Practice Location Address Fax Number:
440-365-1366
Provider Enumeration Date:
11/25/2005

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:  35062321A , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RI0011X , with the licence number: 35062321 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0862491 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2551671 . This is a "PARTNERS PHYSICIAN GROUP MEDICAID #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1023347192 . This is a "MERCY HEALTH PHYSICIANS LORAIN LLC NPI" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1043511595 . This is a "AKRON CARDIOVASCULAR ASSOCIATES TYPE @ NPI #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 3025372 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1841239274 . This is a "PARTNERS PHYSICIAN GROUP TYPE 2 NPI #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 9338635 . This is a "PARTNERS PHYSICIAN GROUP MEDICARE #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".