Ahmad, Shafique
Ahmad, Shafique is an individual health care provider with primary practice located at 3165 Myrtle Ave Suite 2, Granite City IL 62040-5012. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Ahmad, Shafique can be contacted via phone (618) 876-7500.Contact Information
Primary practice address
3165 Myrtle Ave Suite 2
Granite City IL 62040-5012
Phone: (618) 876-7500
Fax: (618) 876-0807
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036048376 | Illinois |
Profile Details
| NPI number | 1700973229 |
|---|---|
| LBN Legal business name | Ahmad, Shafique |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 6th, 2006 |
| Last updated | Jan 26th, 2015 - about 9 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 | 1700973229 | NPPES |
| Illinois | MEDICAID | 036048376 |
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