Provider Demographics
NPI:1245325448
Name:COLUMBUS MEDICAL ONCOLOGY ASSOCIATES, P.C.
Entity type:Organization
Organization Name:COLUMBUS MEDICAL ONCOLOGY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAJID
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-653-2525
Mailing Address - Street 1:2121 WARM SPRINGS RD STE A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-7953
Mailing Address - Country:US
Mailing Address - Phone:706-653-2525
Mailing Address - Fax:706-653-2527
Practice Address - Street 1:2121 WARM SPRINGS RD STE A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-7953
Practice Address - Country:US
Practice Address - Phone:706-653-2525
Practice Address - Fax:706-653-2527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048202174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACH2901OtherRAILROAD MEDICARE
AL009984300Medicaid
GA00881812AMedicaid
GA52702609OtherBCBS OF GEORGIA
GACH2901OtherRAILROAD MEDICARE
F99361Medicare UPIN