Provider Demographics
NPI:1356537716
Name:AHMAD, RIAZ (MD)
Entity type:Individual
Prefix:
First Name:RIAZ
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 1:34055 SOLON RD STE 104
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2663
Mailing Address - Country:US
Mailing Address - Phone:440-349-1100
Mailing Address - Fax:440-349-8160
Practice Address - Street 1:34055 SOLON RD STE 104
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2663
Practice Address - Country:US
Practice Address - Phone:440-349-1100
Practice Address - Fax:440-349-8160
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229588207R00000X
OH35-096756207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3122981Medicaid
OHP00915642Medicare PIN
OHAH4315201Medicare PIN