Provider Demographics
NPI:1407875909
Name:AHMED, DURRE (MD)
Entity Type:Individual
Prefix:DR
First Name:DURRE
Middle Name:
Last Name:AHMED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 SHELLY DR
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-2395
Mailing Address - Country:US
Mailing Address - Phone:724-349-3433
Mailing Address - Fax:724-349-4633
Practice Address - Street 1:2121 SHELLY DR
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-2395
Practice Address - Country:US
Practice Address - Phone:724-349-3433
Practice Address - Fax:724-349-4633
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD058882L173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001338Medicare ID - Type Unspecified
PAG36349Medicare UPIN