Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 04-39003 | KS |
N | 208600000X | Surgeon | 04-39003 | KS |
Y | 2086X0206X | Surgical Oncologist | 04-39003 | KS |
NPI | 1245493501 |
---|---|
Provider Name | Ali Ahmad |
First Address | Wichita, KS 67214 |
Second Address | Wichita, KS 67214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2008 |
Last Update Date | 09/11/2016 |