Provider Demographics
NPI:1841281268
Name:AHMED, WASIM (MD)
Entity type:Individual
Prefix:DR
First Name:WASIM
Middle Name:
Last Name:AHMED
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 1:29 E NORTH ST
Mailing Address - Street 2:STE 203
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-3724
Mailing Address - Country:US
Mailing Address - Phone:724-856-7055
Mailing Address - Fax:724-856-7034
Practice Address - Street 1:29 E NORTH ST
Practice Address - Street 2:STE 203
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-3724
Practice Address - Country:US
Practice Address - Phone:724-856-7055
Practice Address - Fax:724-856-7034
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD072044L207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018133100002Medicaid
PA040453Medicare ID - Type UnspecifiedHGSA
PAG92640Medicare UPIN