Provider Demographics
NPI:1407909781
Name:AHMED, HUMAIRA F (MD)
Entity Type:Individual
Prefix:DR
First Name:HUMAIRA
Middle Name:F
Last Name:AHMED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HUMAIRA
Other - Middle Name:F
Other - Last Name:MOUTI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2101 EAST JEFFERSON STREET
Mailing Address - Street 2:KAISER PERMANENTE, PPQA, 6 WEST, ATTN: THERESA BROOKS
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852
Mailing Address - Country:US
Mailing Address - Phone:301-816-6660
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:201 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4518
Practice Address - Country:US
Practice Address - Phone:703-237-4020
Practice Address - Fax:703-536-1395
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD32639207R00000X
VA0101229690207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H70953Medicare UPIN
010123M92Medicare ID - Type Unspecified