Provider Demographics
NPI:1225113327
Name:ASCHA, AHMAD (MD)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:
Last Name:ASCHA
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 1:9500 MENTOR AVE
Mailing Address - Street 2:SUITE 340
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060
Mailing Address - Country:US
Mailing Address - Phone:440-352-9400
Mailing Address - Fax:440-352-9400
Practice Address - Street 1:9500 MENTOR AVE
Practice Address - Street 2:SUITE 340
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060
Practice Address - Country:US
Practice Address - Phone:440-352-9400
Practice Address - Fax:440-352-9407
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35051961A207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0660584Medicaid
000000133893OtherANTHEM
104696OtherKAISER
2900169OtherUNITED HEALTHCARE
71388OtherQUALCHOICE
0644052OtherAETNA
309615OtherUPMC
020006883OtherRAILROAD MEDICARE
309615OtherUPMC