Provider Demographics
NPI:1396723813
Name:DIRICAN, AHMET F (MD)
Entity type:Individual
Prefix:DR
First Name:AHMET
Middle Name:F
Last Name:DIRICAN
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 1:726 COUNTY ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-5405
Mailing Address - Country:US
Mailing Address - Phone:508-984-5671
Mailing Address - Fax:
Practice Address - Street 1:726 COUNTY ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-5405
Practice Address - Country:US
Practice Address - Phone:508-984-5671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA155176207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000021641OtherBMC HEALTHNET
MA004980OtherSENIOR WHOLE HEALTH
MA22D1015178OtherCLIA
MAJ19903OtherBLUE SHIELD BILLING ID
MA3176576Medicaid
MAP00039394OtherRAILROAD PALMETTO GBA
MA4130813OtherCIGNA BILLING ID
MA00-02362OtherEVERCARE IP
MA155176OtherTUFTS
MA04-46128OtherEVERCARE
MA000000021641OtherBMC HEALTHNET ID
000000033480OtherBMC HEALTHNET UNDER LLC
MA68886OtherHARVARD PILGRIM ID
MA155176OtherTUFTS
MAG61565Medicare UPIN