Provider Demographics
NPI:1790206845
Name:AHMED, TAHA (MD)
Entity type:Individual
Prefix:
First Name:TAHA
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 1:101 WOODRUFF CIRCLE
Mailing Address - Street 2:WMB 1105
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-5612
Mailing Address - Country:US
Mailing Address - Phone:404-712-1504
Mailing Address - Fax:
Practice Address - Street 1:101 WOODRUFF CIRCLE
Practice Address - Street 2:WMB 1105
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-5612
Practice Address - Country:US
Practice Address - Phone:404-712-1504
Practice Address - Fax:404-544-1569
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-29
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.029263207R00000X
KYTP156208M00000X
GA16353207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist