Provider Demographics
NPI:1497918056
Name:AHMED, SHAHZAD (MD, FACC, FSCAI)
Entity Type:Individual
Prefix:DR
First Name:SHAHZAD
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD, FACC, FSCAI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 CHERRY ST
Mailing Address - Street 2:SUITE 11511
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1321
Mailing Address - Country:US
Mailing Address - Phone:215-762-8397
Mailing Address - Fax:
Practice Address - Street 1:501 BATH RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:PA
Practice Address - Zip Code:19007-3101
Practice Address - Country:US
Practice Address - Phone:215-785-5100
Practice Address - Fax:215-785-5101
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD441380207R00000X, 207RI0011X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102538508Medicaid
PA199134Medicare PIN