Provider Demographics
NPI:1336306299
Name:SAEED AHMED MD PSC
Entity Type:Organization
Organization Name:SAEED AHMED MD PSC
Other - Org Name:SAEED AHMED MD PSC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAEED
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-765-4540
Mailing Address - Street 1:1107 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2789
Mailing Address - Country:US
Mailing Address - Phone:270-765-4540
Mailing Address - Fax:270-737-6425
Practice Address - Street 1:1107 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2789
Practice Address - Country:US
Practice Address - Phone:270-765-4540
Practice Address - Fax:270-737-6425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY23813174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1052261OtherPASSPORT HEALTH PLAN
KY1689786337OtherINDIVIDUAL NPI NUMBER
KY64007826Medicaid
KY64007826Medicaid