Provider Demographics
NPI:1629026794
Name:AHMED, WASEEM (MD)
Entity Type:Individual
Prefix:DR
First Name:WASEEM
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12575 FIELDCREEK LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-6633
Mailing Address - Country:US
Mailing Address - Phone:859-583-8224
Mailing Address - Fax:
Practice Address - Street 1:6900 N PECOS RD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89086-4400
Practice Address - Country:US
Practice Address - Phone:702-791-9000
Practice Address - Fax:859-236-6754
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY33677174400000X
KY33677207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64064033Medicaid
KY33677OtherKY LICENSE NUMBER
KY33677OtherKY LICENSE NUMBER
KY0759001Medicare ID - Type UnspecifiedMCARE NUMBER
KY64064033Medicaid