Ahmad, Imtiaz M
Ahmad, Imtiaz M is an individual health care provider with primary practice located at 14645 Hazel Dell Rd , Noblesville IN 46062-7066. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Ahmad, Imtiaz M can be contacted via phone (317) 922-2090.Contact Information
Primary practice address
14645 Hazel Dell Rd
Noblesville IN 46062-7066
Phone: (317) 922-2090
Fax: (317) 574-1875
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01042752A | Indiana |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01042752 | Indiana |
Profile Details
| NPI number | 1104803212 |
|---|---|
| LBN Legal business name | Ahmad, Imtiaz M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 29th, 2005 |
| Last updated | Jun 3rd, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104803212 | NPPES |
| Other | 000000208342 | ANTHEM | |
| MEDICAID | 100366080 | ANTHEM | |
| Other | Q0087386 | ANTHEM |
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