Provider Demographics
NPI:1558439133
Name:AHMAD, ROMMAAN S (DO)
Entity Type:Individual
Prefix:
First Name:ROMMAAN
Middle Name:S
Last Name:AHMAD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8926 WOODYARD RD
Mailing Address - Street 2:SUITE 701
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4220
Mailing Address - Country:US
Mailing Address - Phone:301-856-1682
Mailing Address - Fax:301-856-0964
Practice Address - Street 1:8926 WOODYARD RD
Practice Address - Street 2:SUITE 701
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4220
Practice Address - Country:US
Practice Address - Phone:301-856-1682
Practice Address - Fax:301-856-0964
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101015235208100000X
MDH72937208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1939812OtherCIGNA
231834YZWOtherMETRO MEDICARE
9339815OtherAETNA PPO
CI2264OtherRAILROAD MEDICARE GROUP PTAN
8190869OtherAETNA HMO
975577-01OtherCAREFIRST MARYLAND
P00992726OtherRAILROAD MEDICARE INDIVIDUAL PTAN
11688989OtherCAQH
975577-02OtherCAREFIRST MARYLAND
46950049OtherCAREFIRST NCA
11688989OtherCAQH
CI2264OtherRAILROAD MEDICARE GROUP PTAN
0254450006Medicare NSC