Provider Demographics
NPI:1609144872
Name:FUNDI, AHMED S
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:S
Last Name:FUNDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4237 58TH AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-1936
Mailing Address - Country:US
Mailing Address - Phone:240-396-7414
Mailing Address - Fax:
Practice Address - Street 1:4237 58TH AVE APT 10
Practice Address - Street 2:
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-1936
Practice Address - Country:US
Practice Address - Phone:240-396-7414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health