Provider Demographics
NPI:1437128899
Name:AHMED, SYED (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:
Last Name:AHMED
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 1:4711 CENTERLINE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-1405
Mailing Address - Country:US
Mailing Address - Phone:865-647-3940
Mailing Address - Fax:865-521-7293
Practice Address - Street 1:4711 CENTERLINE DR STE 100
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-1405
Practice Address - Country:US
Practice Address - Phone:865-647-3940
Practice Address - Fax:865-521-7293
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN029559207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1507154Medicaid
TN1507154Medicaid
TN3818431Medicare ID - Type Unspecified
TN38184312Medicare PIN