Provider Demographics
NPI:1801890256
Name:MURAYWID, AHMAD H (MD)
Entity type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:H
Last Name:MURAYWID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3626 S CLARK ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MEXICO
Mailing Address - State:MO
Mailing Address - Zip Code:65265-4104
Mailing Address - Country:US
Mailing Address - Phone:573-581-7366
Mailing Address - Fax:573-581-7422
Practice Address - Street 1:3626 S CLARK ST
Practice Address - Street 2:SUITE A
Practice Address - City:MEXICO
Practice Address - State:MO
Practice Address - Zip Code:65265-4104
Practice Address - Country:US
Practice Address - Phone:573-581-7366
Practice Address - Fax:573-581-7422
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR8158208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200429322Medicaid