Provider Demographics
NPI:1053332676
Name:AHMED, SYEDA S (MD)
Entity Type:Individual
Prefix:MRS
First Name:SYEDA
Middle Name:S
Last Name:AHMED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:S.
Other - Middle Name:S
Other - Last Name:AHMED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:960 W. WOOSTER STREET
Mailing Address - Street 2:SUITE 216
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-2650
Mailing Address - Country:US
Mailing Address - Phone:419-354-3123
Mailing Address - Fax:419-352-3939
Practice Address - Street 1:960 W. WOOSTER STREET
Practice Address - Street 2:SUITE 216
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-2650
Practice Address - Country:US
Practice Address - Phone:419-354-3123
Practice Address - Fax:419-352-3939
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35042410208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0454913Medicaid