1528133188 NPI number — NASIR AHMAD MD

Table of content: NASIR AHMAD MD (NPI 1528133188)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528133188 NPI number — NASIR AHMAD MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AHMAD
Provider First Name:
NASIR
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:
1528133188
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1128 S LINDEN RD
Provider Second Line Business Mailing Address:
SUITE 10
Provider Business Mailing Address City Name:
FLINT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48532-3410
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-230-0383
Provider Business Mailing Address Fax Number:
810-230-0035

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1128 S LINDEN RD
Provider Second Line Business Practice Location Address:
SUITE 10
Provider Business Practice Location Address City Name:
FLINT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48532-3410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-230-0383
Provider Business Practice Location Address Fax Number:
810-230-0035
Provider Enumeration Date:
11/21/2006

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: 207Y00000X , with the licence number:  4301037454 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 19006 . This is a "GREAT LAKES HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 204004 . This is a "MCLAREN HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 383124270100 . This is a "COMMUNITY CHOICE OF MI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0402503271 . This is a "BLUE CARE NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0403271 . This is a "HEALTH PLUS OF MICHIGAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 204004 . This is a "MCLAREN HEALTH ADVANTAGE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2955722 . This is a "MICHIGAN DEPARTMENT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0402503271 . This is a "FEDERAL BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: B43317 . This is a "HEALTH ALLIANCE PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0402503271 . This is a "BLUE CROSS BLUE SHIELD O" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100157 . This is a "GREAT LAKES HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: NA037454 . This is a "STATE LICENSE NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1779158002 . This is a "CIGNA HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2955722 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: C247B . This is a "MCARE" identifier . This identifiers is of the category "OTHER".




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