Provider Demographics
NPI:1952973489
Name:HAJI AHMAD, MARIAM (MD)
Entity Type:Individual
Prefix:
First Name:MARIAM
Middle Name:
Last Name:HAJI AHMAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIAM
Other - Middle Name:
Other - Last Name:HAJI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2301 HOLMES ST. TRUMAN MED CENTER, DEPT OF INTERNAL MED
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108
Mailing Address - Country:US
Mailing Address - Phone:816-404-4175
Mailing Address - Fax:816-404-0003
Practice Address - Street 1:2301 HOLMES ST.TRUMAN MED CENTER, DEPT OF INTERNAL MEDI
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108
Practice Address - Country:US
Practice Address - Phone:816-404-4175
Practice Address - Fax:816-404-0003
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021020331390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program