Provider Demographics
NPI:1760670244
Name:T AHMED MD INTERNAL MEDICINE & GERIATRICS INC
Entity Type:Organization
Organization Name:T AHMED MD INTERNAL MEDICINE & GERIATRICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TOSADDAQ
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-785-5310
Mailing Address - Street 1:7118 LONGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-4560
Mailing Address - Country:US
Mailing Address - Phone:440-785-5310
Mailing Address - Fax:330-247-2801
Practice Address - Street 1:275 GRAHAM RD
Practice Address - Street 2:SUITE 4
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-2203
Practice Address - Country:US
Practice Address - Phone:330-926-9409
Practice Address - Fax:330-926-9428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35069033207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00303767OtherRAIL ROAD MEDICARE NUMBER
OH0272128Medicaid
OHDE6087OtherRAILROAD MEDICARE GROUP
OHP00303767OtherRAIL ROAD MEDICARE NUMBER
G66669Medicare UPIN