Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | CPO 02136 | VA |
N | 222Z00000X | Podiatrist | CPO 02136 | VA |
Y | 224P00000X | Prosthetist | CPO 02136 | VA |
NPI | 1356669378 |
---|---|
Provider Name | Mr. Shamshad Ahmed |
First Address | Huntington, WV 25703-1630 |
Second Address | Huntington, WV 25703-1630 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2010 |
Last Update Date | 20/04/2015 |