Provider Demographics
NPI:1013973429
Name:AHMAD, SALEEM (MD)
Entity Type:Individual
Prefix:
First Name:SALEEM
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 1:1 PRESTIGE PL STE 550
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-6115
Mailing Address - Country:US
Mailing Address - Phone:937-762-1310
Mailing Address - Fax:937-522-8068
Practice Address - Street 1:540 LINCOLN PARK BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-6401
Practice Address - Country:US
Practice Address - Phone:937-298-8058
Practice Address - Fax:937-298-5638
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-05-8765207R00000X, 207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0835109Medicaid
OH0758407Medicare PIN
OH0758409Medicare PIN
060027681Medicare PIN
OHE70969Medicare UPIN
OH0758406Medicare PIN
OH4179601Medicare PIN
OH0758403Medicare PIN
OH0758408Medicare PIN