Provider Demographics
NPI:1154377463
Name:AHMED, ANWAR (MD)
Entity type:Individual
Prefix:DR
First Name:ANWAR
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 1:543 7TH STREET SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52401
Mailing Address - Country:US
Mailing Address - Phone:319-861-7600
Mailing Address - Fax:319-861-7614
Practice Address - Street 1:543 7TH STREET SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401
Practice Address - Country:US
Practice Address - Phone:319-861-7600
Practice Address - Fax:319-861-7614
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036122400207RN0300X
IA33477207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL08100343OtherBCBS IL
IA93122OtherWELLMARK IL POS
IA56266OtherBCBS IA
IL305250Medicare PIN
IL08100343OtherBCBS IL
IB1568Medicare PIN
IL209482Medicare PIN
H08253Medicare UPIN
IA562660001Medicare PIN