Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 12398 | WV |
NPI | 1023093325 |
---|---|
Provider Name | Mr. Ijaz Ahmad |
First Address | Huntington, WV 25702-1236 |
Second Address | Huntington, WV 25702-1236 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2005 |
Last Update Date | 08/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0090974000 | (05) | WV |
0351159 | (05) | OH |
64694862 | (05) | KY |
D91191 | (02) |