1225113327 NPI number — AHMAD ASCHA MD

Table of content: AHMAD ASCHA MD (NPI 1225113327)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225113327 NPI number — AHMAD ASCHA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ASCHA
Provider First Name:
AHMAD
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:
1225113327
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9500 MENTOR AVE
Provider Second Line Business Mailing Address:
SUITE 340
Provider Business Mailing Address City Name:
MENTOR
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44060
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-352-9400
Provider Business Mailing Address Fax Number:
440-352-9400

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9500 MENTOR AVE
Provider Second Line Business Practice Location Address:
SUITE 340
Provider Business Practice Location Address City Name:
MENTOR
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-352-9400
Provider Business Practice Location Address Fax Number:
440-352-9407
Provider Enumeration Date:
10/26/2006

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: 207RG0100X , with the licence number:  35051961A , 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: 0660584 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000133893 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 104696 . This is a "KAISER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2900169 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 71388 . This is a "QUALCHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0644052 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 309615 . This is a "UPMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 020006883 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




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