Provider Demographics
NPI:1023001252
Name:AHMAD, KHALID M (MD)
Entity Type:Individual
Prefix:DR
First Name:KHALID
Middle Name:M
Last Name:AHMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE RIVERVIEW PLAZA 2 WEST
Mailing Address - Street 2:RIVERVIEW MEDICAL CENTER
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701
Mailing Address - Country:US
Mailing Address - Phone:732-530-2421
Mailing Address - Fax:
Practice Address - Street 1:ONE RIVERVIEW PLAZA 2 WEST
Practice Address - Street 2:RIVERVIEW MEDICAL CENTER
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701
Practice Address - Country:US
Practice Address - Phone:732-530-2421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07766900207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0048003Medicaid
NJ084895UWDMedicare PIN
NJ0048003Medicaid