Provider Demographics
NPI:1174845382
Name:EDWARDS, AHMED FARID (LAC)
Entity Type:Individual
Prefix:MR
First Name:AHMED
Middle Name:FARID
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5936 HEADLEY RD
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-1933
Mailing Address - Country:US
Mailing Address - Phone:614-546-7186
Mailing Address - Fax:
Practice Address - Street 1:85 E GAY ST STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-3136
Practice Address - Country:US
Practice Address - Phone:614-546-7186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-16
Last Update Date:2020-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH65-000002171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist