Provider Demographics
NPI:1629240643
Name:AHMED, ADNAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ADNAN
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:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-212-4468
Mailing Address - Fax:859-212-4357
Practice Address - Street 1:7750 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2505
Practice Address - Country:US
Practice Address - Phone:513-298-7325
Practice Address - Fax:513-298-7406
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY43671207P00000X, 207Q00000X, 208M00000X
NC140962207Q00000X
OH35139963208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0084343Medicaid
IN200993310Medicaid
KY7100129700Medicaid
KYK040142OtherKY MEDICARE
KY7100129700Medicaid
KYP400021888Medicare PIN
KYK040140Medicare PIN