Provider Demographics
NPI:1124027719
Name:AHMED, AFTAB (MD)
Entity Type:Individual
Prefix:MR
First Name:AFTAB
Middle Name:
Last Name:AHMED
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 1:250 E LIBERTY ST
Mailing Address - Street 2:801
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1530
Mailing Address - Country:US
Mailing Address - Phone:502-585-2799
Mailing Address - Fax:502-426-5493
Practice Address - Street 1:250 E LIBERTY ST
Practice Address - Street 2:801
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1530
Practice Address - Country:US
Practice Address - Phone:502-585-2799
Practice Address - Fax:502-426-5493
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY31870208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64318702Medicaid
IN200278030Medicaid
KY0707201Medicare ID - Type Unspecified
KY64318702Medicaid