1811948615 NPI number — DR. KAZI WAQAR AHMAD MD

Table of content: DR. KAZI WAQAR AHMAD MD (NPI 1811948615)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811948615 NPI number — DR. KAZI WAQAR AHMAD MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AHMAD
Provider First Name:
KAZI
Provider Middle Name:
WAQAR
Provider Name Prefix Text:
DR.
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:
1811948615
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1910 CHEROKEE AVE S@
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CULLMAN
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35055
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-739-3500
Provider Business Mailing Address Fax Number:
356-775-6119

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10125 W COLONIAL DR STE 212
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OCOEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34761-4200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
833-769-3524
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/15/2006

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: 2084P0800X , with the licence number:  00024328 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: ME114310 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 51537567 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1532606 . This is a "UBH - PLUS SERVICES" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1522606 . This is a "UBH - BASIC SERVICES" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 009940374 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 051557050 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 332100641 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 51557050 . This is a "BCBS OF ALABAMA" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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