Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 2018038482 | MO |
NPI | 1013359173 |
---|---|
Provider Name | Sajjad Ahmad |
First Address | Saint Joseph, MO 64507-7763 |
Second Address | Saint Joseph, MO 64507-7763 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2013 |
Last Update Date | 23/05/2019 |