Provider Demographics
NPI:1841633708
Name:AHMAD, RAYEESA (MD)
Entity type:Individual
Prefix:
First Name:RAYEESA
Middle Name:
Last Name:AHMAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 NAVARRE AVE
Mailing Address - Street 2:SUITE #206
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616
Mailing Address - Country:US
Mailing Address - Phone:419-696-6000
Mailing Address - Fax:419-696-6018
Practice Address - Street 1:2702 NAVARRE AVE
Practice Address - Street 2:STE #206
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616
Practice Address - Country:US
Practice Address - Phone:419-696-6000
Practice Address - Fax:419-696-6018
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35127675207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine