Provider Demographics
NPI:1346951696
Name:AL QAISI, AHMED (PHARMD)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:AL QAISI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6050 DAYBREAK CIR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1641
Mailing Address - Country:US
Mailing Address - Phone:410-531-7837
Mailing Address - Fax:
Practice Address - Street 1:6050 DAYBREAK CIR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1641
Practice Address - Country:US
Practice Address - Phone:410-531-7837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28986183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist