Organization · NPI-2

Ahmad H Ahmad MD Sc

Internal Medicine · Decatur, IL

NPI number1447532924
StatusActive
Last updated in NPPESDec 8, 2011

Details

NPI
1447532924
Entity type
Organization (NPI-2)
Legal business name
Ahmad H Ahmad MD Sc
Organization subpart
No
Enumeration date
Sep 12, 2011
Last updated
Dec 8, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine36108732ILYes

Practice location

1770 E Lake Shore Dr
Ste 201
Decatur, IL 62521-3832

Phone 217-428-7921 · Fax 217-428-7931

Mailing address

1770 E Lake Shore Dr
Ste 201
Decatur, IL 62521-3832

Phone 217-428-7921 · Fax 217-428-7931

Authorized official

Ahmad H Ahmad
Owner
2174287921

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