Provider Demographics
NPI:1093885568
Name:AHMED, ZULFIQAR (MD)
Entity type:Individual
Prefix:
First Name:ZULFIQAR
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 WRIGHTSBORO RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-6220
Mailing Address - Country:US
Mailing Address - Phone:706-733-3406
Mailing Address - Fax:706-738-8757
Practice Address - Street 1:2316 WRIGHTSBORO RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-6220
Practice Address - Country:US
Practice Address - Phone:706-733-3406
Practice Address - Fax:706-738-8757
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301067184207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1093885568Medicaid
TX154316701Medicaid
IN200923120Medicaid
IN200923120Medicaid
TX154316701Medicaid
MI1093885568Medicaid