Provider Demographics
NPI:1154399715
Name:AHMED, SYED RAFEEQ (MD)
Entity type:Individual
Prefix:DR
First Name:SYED
Middle Name:RAFEEQ
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3903 PEACH ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-2803
Mailing Address - Country:US
Mailing Address - Phone:256-766-3003
Mailing Address - Fax:256-766-0898
Practice Address - Street 1:3903 PEACH ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-2803
Practice Address - Country:US
Practice Address - Phone:256-766-3003
Practice Address - Fax:256-766-0898
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15555207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529913100Medicaid
AL000082867Medicare PIN
ALC33527Medicare UPIN