Provider Demographics
NPI:1508949496
Name:AHMED, ABDULHAFIZ A (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDULHAFIZ
Middle Name:A
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 1:1205 GLENVIEW CT
Mailing Address - Street 2:
Mailing Address - City:CHURCHVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21028-1112
Mailing Address - Country:US
Mailing Address - Phone:443-979-2178
Mailing Address - Fax:
Practice Address - Street 1:200 N PHILADELPHIA BLVD STE A
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-2568
Practice Address - Country:US
Practice Address - Phone:443-327-6212
Practice Address - Fax:315-472-2513
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2280032084P0800X
MDD797442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA2379Medicare ID - Type Unspecified