Provider Demographics
NPI:1588871297
Name:AHMED, NASRA MOHAMED (MD)
Entity type:Individual
Prefix:
First Name:NASRA
Middle Name:MOHAMED
Last Name:AHMED
Suffix:
Gender:F
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:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:195-202-4954
Mailing Address - Fax:
Practice Address - Street 1:4300 CLIME RD
Practice Address - Street 2:#110
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-6491
Practice Address - Country:US
Practice Address - Phone:614-272-1100
Practice Address - Fax:614-272-1104
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHXXXXX207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0066074Medicaid
OHH104090Medicare UPIN