Provider Demographics
NPI:1750824793
Name:DR NAHEED AHMAD PC
Entity Type:Organization
Organization Name:DR NAHEED AHMAD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAHEED
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:678-341-1062
Mailing Address - Street 1:1000 BROOKSGLEN DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-1372
Mailing Address - Country:US
Mailing Address - Phone:770-883-4343
Mailing Address - Fax:770-993-4781
Practice Address - Street 1:970 MANSELL RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1506
Practice Address - Country:US
Practice Address - Phone:678-341-1062
Practice Address - Fax:770-993-4781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-23
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA1653152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty