Provider Demographics
NPI:1912671173
Name:AHMAD, NAVEED
Entity Type:Individual
Prefix:
First Name:NAVEED
Middle Name:
Last Name:AHMAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12031 W JEFFERSON TER
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-2042
Mailing Address - Country:US
Mailing Address - Phone:414-202-1295
Mailing Address - Fax:920-636-4435
Practice Address - Street 1:12031 W JEFFERSON TER
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-2042
Practice Address - Country:US
Practice Address - Phone:414-202-1295
Practice Address - Fax:920-636-4435
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty