Provider Demographics
NPI:1982983557
Name:SHAHZAD, AHMAD (MD)
Entity Type:Individual
Prefix:MR
First Name:AHMAD
Middle Name:
Last Name:SHAHZAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 E COVELL BLVD # 508
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-1366
Mailing Address - Country:US
Mailing Address - Phone:802-734-2531
Mailing Address - Fax:
Practice Address - Street 1:3160 FOLSOM BLVD STE 2500
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5267
Practice Address - Country:US
Practice Address - Phone:253-435-3100
Practice Address - Fax:844-660-0690
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD457651207R00000X
MA249727207R00000X
VT042-0013045207R00000X
CAC169910207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine