Provider Demographics
NPI:1245273630
Name:AHMAD, JAVED (MD)
Entity type:Individual
Prefix:
First Name:JAVED
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 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:335 LAMBS GAP RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-2784
Practice Address - Country:US
Practice Address - Phone:717-591-1425
Practice Address - Fax:717-591-1365
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429343207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001881422OtherHIGHMARK BLUE SHIELD
PA101884914Medicaid
PA000000190382OtherUNISON
NY00027645201OtherUNIVERA
PA001881422OtherHIGHMARK BLUE SHIELD
NY00027645201OtherUNIVERA