Provider Demographics
NPI:1750511218
Name:AHMAD, MUFTI N (MD)
Entity Type:Individual
Prefix:
First Name:MUFTI
Middle Name:N
Last Name:AHMAD
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 1:3035 HAMILTON MASON RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-5544
Mailing Address - Country:US
Mailing Address - Phone:513-853-1300
Mailing Address - Fax:513-451-4118
Practice Address - Street 1:3035 HAMILTON MASON RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45011-5544
Practice Address - Country:US
Practice Address - Phone:513-853-1300
Practice Address - Fax:513-451-4118
Is Sole Proprietor?:No
Enumeration Date:2009-07-19
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01073478A207RX0202X
OH35.099115207RH0003X
NC2016-00266207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300027299Medicaid
OH35099115OtherOH MEDICAL LICENSE
OH0065378Medicaid
SCNC2759Medicaid
INP01307634OtherMEDICARE RR PTAN
INP01307634OtherMEDICARE RR PTAN
NCNCT045AMedicare PIN