Provider Demographics
NPI:1275731358
Name:AHMED, WESAM (MD)
Entity Type:Individual
Prefix:
First Name:WESAM
Middle Name:
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 1:2501 N ORANGE AVE
Mailing Address - Street 2:SUITE 581
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4647
Mailing Address - Country:US
Mailing Address - Phone:407-303-2070
Mailing Address - Fax:407-303-2071
Practice Address - Street 1:2501 N ORANGE AVE
Practice Address - Street 2:SUITE 581
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4647
Practice Address - Country:US
Practice Address - Phone:407-303-2070
Practice Address - Fax:407-303-2071
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP01158207R00000X
FLME118177207RH0003X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine