Provider Demographics
NPI:1164042487
Name:AHMADI, NEGAR (MD)
Entity Type:Individual
Prefix:MS
First Name:NEGAR
Middle Name:
Last Name:AHMADI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 MELBOURNE STREET, UNIT #1
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:ON
Mailing Address - Zip Code:L8P 2A5
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:77 MELBOURNE STREET, UNIT #1
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:ON
Practice Address - Zip Code:L8P 2A5
Practice Address - Country:CA
Practice Address - Phone:613-769-6818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-17
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program