Provider Demographics
NPI:1457358053
Name:AHMED, M. LUQMAN (MD)
Entity Type:Individual
Prefix:
First Name:M.
Middle Name:LUQMAN
Last Name:AHMED
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 1:185 MITYLENE PARK LN
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7302
Mailing Address - Country:US
Mailing Address - Phone:334-387-0948
Mailing Address - Fax:334-387-0955
Practice Address - Street 1:185 MITYLENE PARK LN
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7302
Practice Address - Country:US
Practice Address - Phone:334-387-0948
Practice Address - Fax:334-387-0955
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19053207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000036787Medicaid
AL000036786Medicaid
ALF33630Medicare UPIN
AL000036787Medicare ID - Type Unspecified
AL000036786Medicare ID - Type Unspecified