Provider Demographics
NPI:1154634798
Name:AHMED, NAWAZ
Entity Type:Individual
Prefix:
First Name:NAWAZ
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 TALL GRASS CIR
Mailing Address - Street 2:308
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-6926
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:155 5TH ST NE
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-3332
Practice Address - Country:US
Practice Address - Phone:330-615-3000
Practice Address - Fax:330-615-3030
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-25
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.121926208M00000X
OH57.017641207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine