Provider Demographics
NPI:1588827893
Name:AHMED, KHULOOD T (MD)
Entity type:Individual
Prefix:
First Name:KHULOOD
Middle Name:T
Last Name:AHMED
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:PO BOX 1239
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-1239
Mailing Address - Country:US
Mailing Address - Phone:573-629-3500
Mailing Address - Fax:573-629-3429
Practice Address - Street 1:101 S FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-7637
Practice Address - Country:US
Practice Address - Phone:573-884-7600
Practice Address - Fax:573-884-8200
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011027131207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology