Individual provider · NPI-1

Tanam Ahmed, MD

Family Medicine · Palm Coast, FL

NPI number1043475155
StatusActive
Last updated in NPPESJan 8, 2013

Details

NPI
1043475155
Entity type
Individual (NPI-1)
Name
Tanam Ahmed
Credential
MD
Sex
Female
Sole proprietor
No
Enumeration date
Jul 29, 2008
Last updated
Jan 8, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineME109737FLYes
390200000X Student in an Organized Health Care Education/Training ProgramMT193279PA

Practice location

120 Cypress Edge Dr
Suite 207
Palm Coast, FL 32164-8453

Phone 386-586-4390 · Fax 386-586-4392

Mailing address

120 Cypress Edge Dr
Suite 207
Palm Coast, FL 32164-8453

Phone 386-586-4390 · Fax 386-586-4392

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