Provider Demographics
NPI:1770653487
Name:AHMED, WALEED (MD)
Entity type:Individual
Prefix:DR
First Name:WALEED
Middle Name:
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:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:12750 SAINT FRANCIS DR STE 320
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-0264
Practice Address - Country:US
Practice Address - Phone:219-662-0077
Practice Address - Fax:219-618-6701
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361310062085U0001X, 207RC0000X, 207UN0901X
CAA96991207R00000X
IN01091737A207UN0901X, 2085U0001X, 207RC0000X
TXU0951207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036131006Medicaid
IL206147OtherMEDICARE PTAN (GROUP)
IL206147123OtherMEDICARE PTAN (INDIVIDUAL)
MAAH A34866Medicare ID - Type Unspecified