Provider Demographics
NPI:1063091569
Name:BAGHDADY, AHMED (DO)
Entity type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:BAGHDADY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 E 125TH PL
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-7546
Mailing Address - Country:US
Mailing Address - Phone:219-689-3315
Mailing Address - Fax:
Practice Address - Street 1:27483 DEQUINDRE RD STE 301
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-5715
Practice Address - Country:US
Practice Address - Phone:586-576-4157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-03
Last Update Date:2021-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program