Provider Demographics
NPI:1790971885
Name:AHMED, SHAMEELA N (MD)
Entity Type:Individual
Prefix:
First Name:SHAMEELA
Middle Name:N
Last Name:AHMED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 ATOKA MCLAUGHLIN DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:ATOKA
Mailing Address - State:TN
Mailing Address - Zip Code:38004-4824
Mailing Address - Country:US
Mailing Address - Phone:901-840-1083
Mailing Address - Fax:901-837-0183
Practice Address - Street 1:340 ATOKA MCLAUGHLIN DR
Practice Address - Street 2:SUITE C
Practice Address - City:ATOKA
Practice Address - State:TN
Practice Address - Zip Code:38004-4824
Practice Address - Country:US
Practice Address - Phone:901-840-1083
Practice Address - Fax:901-837-0183
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36864174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist