1669755476 NPI number — BILAL AHMAD MD, PA

Table of content: (NPI 1669755476)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669755476 NPI number — BILAL AHMAD MD, PA

Organization/Personal Information

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

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:
1669755476
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/29/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1351 MASON FARM RD
Provider Second Line Business Mailing Address:
APT# 122
Provider Business Mailing Address City Name:
CHAPEL HILL
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27514-4718
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-529-8923
Provider Business Mailing Address Fax Number:
919-967-1753

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2041 WILLOW RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27406-3831
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-529-8923
Provider Business Practice Location Address Fax Number:
919-967-1753
Provider Enumeration Date:
09/28/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
AHMAD
Authorized Official First Name:
BILAL
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
336-529-8923

Provider Taxonomy Codes

  • Taxonomy code: 207RG0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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