Provider Demographics
NPI:1376501312
Name:AHMED, NAVEEDA TABASSUM (MD)
Entity Type:Individual
Prefix:DR
First Name:NAVEEDA
Middle Name:TABASSUM
Last Name:AHMED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:811 13TH ST
Mailing Address - Street 2:SUITE 14
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2700
Mailing Address - Country:US
Mailing Address - Phone:706-828-0043
Mailing Address - Fax:706-828-0450
Practice Address - Street 1:811 13TH ST
Practice Address - Street 2:SUITE 14
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2700
Practice Address - Country:US
Practice Address - Phone:706-828-0043
Practice Address - Fax:706-828-0450
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA047287174400000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00909323AMedicaid
GA66BBBFNMedicare ID - Type Unspecified
GA00909323AMedicaid