Provider Demographics
NPI:1508374570
Name:WAHEED AHMAD
Entity Type:Organization
Organization Name:WAHEED AHMAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WAHEED
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-262-4746
Mailing Address - Street 1:1919 STATE ST.
Mailing Address - Street 2:308
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-6806
Mailing Address - Country:US
Mailing Address - Phone:812-945-3372
Mailing Address - Fax:812-945-3520
Practice Address - Street 1:1919 STATE STREET
Practice Address - Street 2:308
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-6806
Practice Address - Country:US
Practice Address - Phone:812-945-3372
Practice Address - Fax:812-945-3520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-11
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01024158A2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty