Provider Demographics
NPI:1518461961
Name:ELAKKAD, AHMED (MD)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:ELAKKAD
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 1:2318 LANGHORNE ROAD
Mailing Address - Street 2:CMG NEUROSURGERY 2138 MAIN
Mailing Address - City:LYNCGBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CMG NEUROSURGERY 2138 MAIN
Practice Address - Street 2:2318 LANGHORNE ROAD
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501
Practice Address - Country:US
Practice Address - Phone:434-947-3920
Practice Address - Fax:434-947-3924
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-21
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01084061A2085R0202X
390200000X
VA01012727852085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program