Provider Demographics
NPI:1356347421
Name:ABDUL KARIM, AHMAD (MD)
Entity type:Individual
Prefix:
First Name:AHMAD
Middle Name:
Last Name:ABDUL KARIM
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 1:9000 N MAIN ST
Mailing Address - Street 2:STE 101
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-1184
Mailing Address - Country:US
Mailing Address - Phone:937-832-2425
Mailing Address - Fax:937-832-9804
Practice Address - Street 1:9000 N MAIN ST
Practice Address - Street 2:STE 101
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-1184
Practice Address - Country:US
Practice Address - Phone:937-832-2425
Practice Address - Fax:937-832-9804
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35063434A207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0928536Medicaid
OHF70993Medicare UPIN
OHAB0803265Medicare ID - Type Unspecified
OHH081510Medicare PIN