Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | MD426544 | PA |
NPI | 1386618676 |
---|---|
Provider Name | Dr. Shaik Mohd L Ahmed |
First Address | Danville, PA 17822-4903 |
Second Address | Danville, PA 17822-5208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 19/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013184930001 | (05) | PA |
I30927 | (02) |