Provider Demographics
NPI:1487654182
Name:AHMAD, SYED M (MD/ RHEUMATOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:M
Last Name:AHMAD
Suffix:
Gender:M
Credentials:MD/ RHEUMATOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 WESTWOOD MEDICAL PARK
Mailing Address - Street 2:P.O. BOX 1008
Mailing Address - City:BLUEFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24605-2000
Mailing Address - Country:US
Mailing Address - Phone:276-326-2638
Mailing Address - Fax:276-326-2360
Practice Address - Street 1:11 WESTWOOD MEDICAL PARK
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:VA
Practice Address - Zip Code:24605-2000
Practice Address - Country:US
Practice Address - Phone:276-326-2638
Practice Address - Fax:276-326-2360
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101036550174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006065813Medicaid
WV0084626000Medicaid
VA027097OtherBCBS
VA006065813Medicaid
VA110001675Medicare PIN
WV0084626000Medicaid
VA49D0672463Medicare Oscar/Certification