Provider Demographics
NPI:1770542946
Name:ALIMAM, AMMAR (MD)
Entity type:Individual
Prefix:DR
First Name:AMMAR
Middle Name:
Last Name:ALIMAM
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:PO BOX 2379
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-2379
Mailing Address - Country:US
Mailing Address - Phone:606-408-9571
Mailing Address - Fax:606-408-6061
Practice Address - Street 1:446 N READING RD
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-9802
Practice Address - Country:US
Practice Address - Phone:717-738-4334
Practice Address - Fax:717-738-3289
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA70224207RC0200X, 207RP1001X, 207RS0012X
KY55521207RC0200X, 207RP1001X, 207RS0010X
PAMD068085L207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8534900Medicaid
KY7100727760Medicaid
NJ048384CMXMedicare PIN
NJ140211ZB5QMedicare PIN