Provider Demographics
NPI:1427210111
Name:AHMAD, MISBAH HAQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:MISBAH
Middle Name:HAQUE
Last Name:AHMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 JOHN JAMES AUDOBON PKWY
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226
Mailing Address - Country:US
Mailing Address - Phone:716-204-4500
Mailing Address - Fax:716-204-4501
Practice Address - Street 1:462 GRIDER ST
Practice Address - Street 2:RM 786
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215
Practice Address - Country:US
Practice Address - Phone:716-961-6995
Practice Address - Fax:716-898-5276
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY262240207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine