Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 9700837 | NC |
NPI | 1285715664 |
---|---|
Provider Name | Maqsood Ahmed |
First Address | Goldsboro, NC 27534-6513 |
Second Address | Goldsboro, NC 27534-6513 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 11/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0284X | NC BLUE CROSS BLUE SHIELD (01) | NC |
89011NV | (05) | NC |
891118A | (05) | NC |
G53129 | (02) | NC |