Ahmad, Mohammad Imtiaz

Ahmad, Mohammad Imtiaz is an individual health care provider with primary practice located at 635 East Baseline Road , Phoenix AZ 85042-6551. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Ahmad, Mohammad Imtiaz can be contacted via phone (602) 243-7277.

Contact Information

Primary practice address
635 East Baseline Road Phoenix AZ 85042-6551
Phone: (602) 243-7277
Fax: (602) 243-5019
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X A38013 California
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 13260 Arizona

Profile Details

NPI number 1417055526
LBN Legal business name Ahmad, Mohammad Imtiaz
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Nov 29th, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417055526 NPPES
Arizona MEDICAID 20503
Arizona MEDICAID 00A380130
Arizona MEDICAID 205303

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