Provider Demographics
NPI:1740265578
Name:AHMED, ASHRAF NABEL (MD)
Entity type:Individual
Prefix:
First Name:ASHRAF
Middle Name:NABEL
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 1:2015 MAXWELL AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47711-4359
Mailing Address - Country:US
Mailing Address - Phone:812-422-7974
Mailing Address - Fax:
Practice Address - Street 1:2015 MAXWELL AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711-4359
Practice Address - Country:US
Practice Address - Phone:812-422-7974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI46816-0202084N0400X
IN01071532A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ININ1021Medicare PIN
WIG98476Medicare UPIN
WI008770073Medicare Oscar/Certification
WIP00146393Medicare Oscar/Certification