1699755009 NPI number — SAGHIR AHMED MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699755009 NPI number — SAGHIR AHMED MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

AHMED

Provider First Name:

SAGHIR

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

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:

1699755009

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

01/20/2022

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

890 2ND ST

Provider Second Line Business Mailing Address:

SUITE 201

Provider Business Mailing Address City Name:

MACON

Provider Business Mailing Address State Name:

GA

Provider Business Mailing Address Postal Code:

31201-6863

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

478-745-4322

Provider Business Mailing Address Fax Number:

478-750-8789

Provider First Line Business Practice Location Address:

890 2ND ST

Provider Second Line Business Practice Location Address:

SUITE 201

Provider Business Practice Location Address City Name:

MACON

Provider Business Practice Location Address State Name:

GA

Provider Business Practice Location Address Postal Code:

31201-6863

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

478-745-4322

Provider Business Practice Location Address Fax Number:

478-750-8789

Provider Enumeration Date:

01/20/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 174400000X , with the licence number:  044664 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 000867325I , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
• Identifier: 000867325N , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
• Identifier: 000867325R , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
• Identifier: 000867325U , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
• Identifier: 000867325J , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
• Identifier: 000867325M , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
• Identifier: 000867325L , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
• Identifier: 000867325O , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
• Identifier: 000867325P , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
• Identifier: 000867325H , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
• Identifier: 000867325Q , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
• Identifier: 180599206M , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
• Identifier: 000867325G , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
• Identifier: 000867325K , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".