Provider Demographics
NPI:1700893104
Name:AHMAD, ARSAL (MD)
Entity Type:Individual
Prefix:
First Name:ARSAL
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 1:6651 FRANK AVE NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-8442
Mailing Address - Country:US
Mailing Address - Phone:330-498-9865
Mailing Address - Fax:
Practice Address - Street 1:6651 FRANK AVE NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-7259
Practice Address - Country:US
Practice Address - Phone:330-498-9865
Practice Address - Fax:330-498-9869
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-088211208VP0000X
OH35088211208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000507894OtherANTHEM
OHP00356103OtherRAILROAD
OH2675163Medicaid
OH4192074Medicare PIN
OH000000507894OtherANTHEM
OH4192073Medicare PIN
OHI60703Medicare UPIN
OH2675163Medicaid