Provider Demographics
NPI:1992082267
Name:TAHIR AHMED MD PC
Entity type:Organization
Organization Name:TAHIR AHMED MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TAHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-963-0367
Mailing Address - Street 1:253 TERRY DR
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641-4603
Mailing Address - Country:US
Mailing Address - Phone:276-963-0367
Mailing Address - Fax:276-963-0367
Practice Address - Street 1:2949 FRONT ST
Practice Address - Street 2:WOUND CENTER
Practice Address - City:RICHLANDS
Practice Address - State:VA
Practice Address - Zip Code:24641-2010
Practice Address - Country:US
Practice Address - Phone:276-596-6600
Practice Address - Fax:276-596-6610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235095261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center