Provider Demographics
NPI:1386199495
Name:AGAMEYA, AHMED MOHAMED (MD)
Entity Type:Individual
Prefix:DR
First Name:AHMED
Middle Name:MOHAMED
Last Name:AGAMEYA
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 1:900 MAIN ST STE 630
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61602-5024
Mailing Address - Country:US
Mailing Address - Phone:309-672-4433
Mailing Address - Fax:
Practice Address - Street 1:900 MAIN ST STE 630
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61602-5024
Practice Address - Country:US
Practice Address - Phone:309-627-4433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-18
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.15842207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease