1932165396 NPI number — TAHMINA K AHMED M.D

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932165396 NPI number — TAHMINA K AHMED M.D

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

AHMED

Provider First Name:

TAHMINA

Provider Middle Name:

K

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D

Provider Gender Code:

F

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:

1932165396

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

10/31/2011

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

9716 FOREST GROVE DR

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

SILVER SPRING

Provider Business Mailing Address State Name:

MD

Provider Business Mailing Address Postal Code:

20910-1414

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

301-681-8797

Provider Business Mailing Address Fax Number:

301-681-8797

Provider First Line Business Practice Location Address:

831 UNIVERSITY BLVD E

Provider Second Line Business Practice Location Address:

SUITE 27

Provider Business Practice Location Address City Name:

SILVER SPRING

Provider Business Practice Location Address State Name:

MD

Provider Business Practice Location Address Postal Code:

20903-2916

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

301-445-9595

Provider Business Practice Location Address Fax Number:

301-445-4499

Provider Enumeration Date:

04/25/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207R00000X , with the licence number:  D0060100 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
• Taxonomy code: 207R00000X , with the licence number: MD034303 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

• Identifier: 101373 . This is a "PRIORITY PARTNER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 190979 . This is a "AMERIGROUP, MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 1149946 . This is a "AETNA HMO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 552 ATK . This is a "BCBS MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: J4970001 . This is a "BCBS DC" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
• Identifier: 5655220 . This is a "COMMUNITY CARE NETWORKPPO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 101373 . This is a "JOHNS HOPKINS HEALTH CARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 035154200 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
• Identifier: 403153900 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
• Identifier: 7582511 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".