Provider Demographics
NPI:1558393421
Name:AHMED, MOHAMED SAHABUDDIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:SAHABUDDIN
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:130WEST. KINGSBRIDGE ROAD, BRONX VA MEDICAL CENTER.
Mailing Address - Street 2:3D10
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468
Mailing Address - Country:US
Mailing Address - Phone:718-584-9000
Mailing Address - Fax:718-741-4701
Practice Address - Street 1:130WEST. KINGSBRIDGE ROAD, BRONX VA MEDICAL CENTER.
Practice Address - Street 2:3D10
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468
Practice Address - Country:US
Practice Address - Phone:718-584-9000
Practice Address - Fax:718-741-4701
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220147174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist