Provider Demographics
NPI:1558364059
Name:AHMAD, NAUSHABA (MD)
Entity Type:Individual
Prefix:DR
First Name:NAUSHABA
Middle Name:
Last Name:AHMAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2980 STAUNTON
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25702-0639
Mailing Address - Country:US
Mailing Address - Phone:304-654-9945
Mailing Address - Fax:
Practice Address - Street 1:2980 STAUNTON RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-9622
Practice Address - Country:US
Practice Address - Phone:304-654-9945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21110174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1810536000Medicaid
H96239Medicare UPIN
WVAH4119441Medicare ID - Type Unspecified
WV1810536000Medicaid