Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 20242 | AL |
NPI | 1003856600 |
---|---|
Provider Name | Ali Ahmed |
First Address | Birmingham, AL 35255-5310 |
Second Address | Birmingham, AL 35233 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 21/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000041056 | (05) | AL |
000041056 | BLUE CROSS (01) | AL |
009957355 | (05) | AL |
051522972 | BLUE CROSS (01) | AL |
110189078 | RAILROAD MEDICARE (01) | AL |
G91270 | VIVA (01) | AL |