Provider Demographics
NPI:1134644941
Name:ALSARAH, AHMAD (MD)
Entity Type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:
Last Name:ALSARAH
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 1:555 KENSINGTON LAKE CIR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-3886
Mailing Address - Country:US
Mailing Address - Phone:517-897-0172
Mailing Address - Fax:
Practice Address - Street 1:1110 BELL SHOALS RD STE 102
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-8813
Practice Address - Country:US
Practice Address - Phone:813-315-9435
Practice Address - Fax:813-409-3847
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI158651207R00000X
FL158651207R00000X
FLME158651208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine