Individual provider · NPI-1

Boualem Ait Ahmed, mda

Technician, Other · Denver, CO

NPI number1306067111
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1306067111
Entity type
Individual (NPI-1)
Name
Boualem Ait Ahmed
Credential
mda
Sex
Male
Sole proprietor
No
Enumeration date
May 1, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
247200000X Technician, Other––Yes

Practice location

2045 Franklin Street
Denver, CO 80205

Phone 303-743-5855

Mailing address

1017 S Birch St
#b306
Glendale, CO 80246

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