Provider Demographics
NPI:1508827593
Name:ATIA, AHMED M (MD)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:M
Last Name:ATIA
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 1:907 SUMNER ST M201
Mailing Address - Street 2:GUARDIAN ANESTHESIA INC
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072
Mailing Address - Country:US
Mailing Address - Phone:781-344-2325
Mailing Address - Fax:781-341-8544
Practice Address - Street 1:907 SUMNER ST
Practice Address - Street 2:M201
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072
Practice Address - Country:US
Practice Address - Phone:508-941-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA216741207LP2900X
RIMD11089207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI410922OtherBLUECHIP
611000600OtherDOL
MAAA30366OtherHPHC
RI30902OtherBCBS
RI7010560Medicaid
8983845OtherCIGNA
MAAA47844OtherHPHC
MA464616OtherTUFTS
MA6110000600OtherDOL
MA67400OtherFALLON
MA7017564OtherAETNA
7017564OtherAETNA
MAJ27035OtherBCBS
MA46416OtherTUFTS
J27035OtherBCBS
20270527002OtherTRICARE
AA47844OtherHPHC
202010504OtherUNITEDHEALTH
202705274OtherUNITEDHEALTH
202705274OtherGREAT WEST
MA2038251Medicaid
97252802OtherNETWORK HEALTH
RI31395OtherNEIGBORHOOD HEALTH
MAJ27035OtherBCBS
AA47844OtherHPHC
97252802OtherNETWORK HEALTH
MA67400OtherFALLON
7017564OtherAETNA
RI7058345Medicare PIN