Provider Demographics
NPI:1205824810
Name:AHMED, AMIR R (MD)
Entity Type:Individual
Prefix:MR
First Name:AMIR
Middle Name:R
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 1:1111 MEDICAL PLAZA DR
Mailing Address - Street 2:STE 250
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3477
Mailing Address - Country:US
Mailing Address - Phone:865-483-4366
Mailing Address - Fax:865-483-5957
Practice Address - Street 1:3 RICHLAND MEDICAL PARK DR STE 120
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6850
Practice Address - Country:US
Practice Address - Phone:803-434-8866
Practice Address - Fax:803-933-3049
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022014629207RG0100X
NC2013-00585207RG0100X
TN52921207RG0100X
SC39148207RG0100X
TXL8585207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167477202Medicaid
SCNC2497Medicaid
P00197603OtherRAILROAD MEDICARE
NC1205824810Medicaid
TX8K8338OtherBC/BS OF TEXAS
P00197603OtherRAILROAD MEDICARE