Provider Demographics
NPI:1326003401
Name:AHMAD, SAMEER I (MD)
Entity Type:Individual
Prefix:
First Name:SAMEER
Middle Name:I
Last Name:AHMAD
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:PO BOX 465
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20172-0465
Mailing Address - Country:US
Mailing Address - Phone:703-689-2020
Mailing Address - Fax:703-563-3769
Practice Address - Street 1:171 ELDEN ST
Practice Address - Street 2:STE 100
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4834
Practice Address - Country:US
Practice Address - Phone:703-689-2020
Practice Address - Fax:703-485-1153
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD53502207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG68376Medicare UPIN