Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | 35037323A | OH |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 35037323A | OH |
NPI | 1639266174 |
---|---|
Provider Name | Mirza N Ahmad |
First Address | Canton, OH 44718 |
Second Address | Canton, OH 44718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 04/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0255325 | (05) | OH |
A14809 | (02) | OH |