Provider Demographics
NPI:1356324115
Name:AHMED, ISMAIL SULEMAN (MD)
Entity Type:Individual
Prefix:
First Name:ISMAIL
Middle Name:SULEMAN
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:PO BOX 636643
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6643
Mailing Address - Country:US
Mailing Address - Phone:440-989-3801
Mailing Address - Fax:440-960-0264
Practice Address - Street 1:1120 E BROAD ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-6306
Practice Address - Country:US
Practice Address - Phone:440-366-2239
Practice Address - Fax:440-365-1366
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35062321A207RC0000X
OH35062321207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0862491Medicaid
OH2551671OtherPARTNERS PHYSICIAN GROUP MEDICAID #
OH1023347192OtherMERCY HEALTH PHYSICIANS LORAIN LLC NPI
OH1043511595OtherAKRON CARDIOVASCULAR ASSOCIATES TYPE @ NPI #
OH3025372Medicaid
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH9338635OtherPARTNERS PHYSICIAN GROUP MEDICARE #
OH9389631Medicare PIN
OH0862491Medicaid