Provider Demographics
NPI:1013271485
Name:AHMAD, HAMAD (MD)
Entity Type:Individual
Prefix:DR
First Name:HAMAD
Middle Name:
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 1:4772 NAVY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MILLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38053-1927
Mailing Address - Country:US
Mailing Address - Phone:901-873-0930
Mailing Address - Fax:901-873-0931
Practice Address - Street 1:4772 NAVY RD
Practice Address - Street 2:SUITE A
Practice Address - City:MILLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38053-1927
Practice Address - Country:US
Practice Address - Phone:901-873-0930
Practice Address - Fax:901-873-0931
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-29
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-12132207P00000X, 207Q00000X
TN48437207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ021626Medicaid
TN103I085091Medicare PIN