Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | DR.0066109 | CO |
NPI | 1003377938 |
---|---|
Provider Name | Dr. Mohammad Usman Ahmad |
First Address | Stanford, CA 94305-2200 |
Second Address | Stanford, CA 94305-2200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2019 |
Last Update Date | 26/01/2022 |