Provider Demographics
NPI:1255390092
Name:IRSHAD AHMED MD PC
Entity type:Organization
Organization Name:IRSHAD AHMED MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IRSHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-524-0524
Mailing Address - Street 1:2801 BOULEVARD
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-2323
Mailing Address - Country:US
Mailing Address - Phone:804-524-0524
Mailing Address - Fax:804-524-0520
Practice Address - Street 1:2801 BOULEVARD
Practice Address - Street 2:SUITE B
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-2323
Practice Address - Country:US
Practice Address - Phone:804-524-0524
Practice Address - Fax:804-524-0520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1255390092OtherGROUP NPI NUMBER
VA005867151Medicaid
VAC10112Medicare PIN
VA1255390092OtherGROUP NPI NUMBER
G36623Medicare UPIN