Provider Demographics
NPI:1740225796
Name:AHMED, MOHAMMED AQUEEL (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:AQUEEL
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 1:189 COURTS LN
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-9018
Mailing Address - Country:US
Mailing Address - Phone:501-821-7727
Mailing Address - Fax:
Practice Address - Street 1:189 COURTS LN
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-9018
Practice Address - Country:US
Practice Address - Phone:501-821-7727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-4351207P00000X
TXM4693207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR158794001Medicaid
AR5N456Medicare ID - Type Unspecified
AR248572YJRUMedicare PIN
AR158794001Medicaid