Provider Demographics
NPI:1306323266
Name:ASHFAQ, AMMAR ALI (MD)
Entity type:Individual
Prefix:
First Name:AMMAR ALI
Middle Name:
Last Name:ASHFAQ
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 1:3855 BLAIR MILL RD APT 229G
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-2840
Mailing Address - Country:US
Mailing Address - Phone:267-879-5445
Mailing Address - Fax:
Practice Address - Street 1:1200 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3788
Practice Address - Country:US
Practice Address - Phone:215-481-2191
Practice Address - Fax:215-481-4361
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD474939207R00000X
PAMT214899207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine