Provider Demographics
NPI:1124366240
Name:AHMED, JAHANGIR MUNIR (MD)
Entity Type:Individual
Prefix:
First Name:JAHANGIR
Middle Name:MUNIR
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 1:4287 HARRISON BLVD # 156
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-3101
Mailing Address - Country:US
Mailing Address - Phone:385-350-8500
Mailing Address - Fax:385-350-8555
Practice Address - Street 1:4345 HARRISON BLVD STE 101
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-3103
Practice Address - Country:US
Practice Address - Phone:385-350-8500
Practice Address - Fax:385-350-8555
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-24
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115846207R00000X, 208M00000X
UT11713622-1205207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty