Provider Demographics
NPI:1679087399
Name:SAEED, AHMAD KHALID (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:KHALID
Last Name:SAEED
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N 200 W APT 301
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84103-4551
Mailing Address - Country:US
Mailing Address - Phone:801-833-2333
Mailing Address - Fax:
Practice Address - Street 1:3336 S PIONEER PKWY STE 201
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84120-2085
Practice Address - Country:US
Practice Address - Phone:801-250-9838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8294013-126363A00000X
UT8294013-1206363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant