Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 036146201 | IL |
N | 207PP0204X | Pediatric Emergency Physician | ME129227 | FL |
NPI | 1699922807 |
---|---|
Provider Name | Qadeer Ahmed |
First Address | Jacksonville, FL 32256-0532 |
Second Address | Orlando, FL 32827-7402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2008 |
Last Update Date | 17/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
018990900 | (05) | FL |