Provider Demographics
NPI:1396190542
Name:JAMA, AHMED
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:JAMA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 NASHBORO GREENS WAY
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-3931
Mailing Address - Country:US
Mailing Address - Phone:615-423-1361
Mailing Address - Fax:
Practice Address - Street 1:304 NASHBORO GREENS WAY
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-3931
Practice Address - Country:US
Practice Address - Phone:615-423-1361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN192897261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care