Provider Demographics
NPI:1740415058
Name:QUASEM, AHMED KHALEEL (MD)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:KHALEEL
Last Name:QUASEM
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 1:1410 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-2940
Mailing Address - Country:US
Mailing Address - Phone:563-244-5695
Mailing Address - Fax:
Practice Address - Street 1:1410 N 4TH ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-2940
Practice Address - Country:US
Practice Address - Phone:563-244-5695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-17
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA40210208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist