Provider Demographics
NPI:1043560220
Name:AHMED, ABDULDAYEM (DC)
Entity Type:Individual
Prefix:
First Name:ABDULDAYEM
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9925 DIX
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48120-1593
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9925 DIX
Practice Address - Street 2:SUITE 102
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48120-1593
Practice Address - Country:US
Practice Address - Phone:313-841-1470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1777261111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor