Provider Demographics
NPI:1699776369
Name:AHMAD, IFTIKHAR (MD)
Entity type:Individual
Prefix:
First Name:IFTIKHAR
Middle Name:
Last Name:AHMAD
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 1:44 W 21ST ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NORTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18067-1221
Mailing Address - Country:US
Mailing Address - Phone:610-261-0999
Mailing Address - Fax:610-261-2187
Practice Address - Street 1:6649 CHRISPHALT DR
Practice Address - Street 2:SUITE 101
Practice Address - City:BATH
Practice Address - State:PA
Practice Address - Zip Code:18014-8500
Practice Address - Country:US
Practice Address - Phone:610-837-6614
Practice Address - Fax:610-261-2187
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD062722-L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF84147Medicare UPIN