Provider Demographics
NPI:1063460426
Name:AHMAD, IRFAN (MD)
Entity Type:Individual
Prefix:DR
First Name:IRFAN
Middle Name:
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 1:68 CUMBERLAND ST STE 205
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-3331
Mailing Address - Country:US
Mailing Address - Phone:401-765-4100
Mailing Address - Fax:401-765-2300
Practice Address - Street 1:68 CUMBERLAND ST STE 205
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3331
Practice Address - Country:US
Practice Address - Phone:401-765-4100
Practice Address - Fax:401-765-2300
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD11507207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9094990Medicaid
RI119003683Medicare ID - Type Unspecified
RI9094990Medicaid