Provider Demographics
NPI:1992955603
Name:AHMED, TAGELDIN MOHAMED (MD)
Entity type:Individual
Prefix:
First Name:TAGELDIN
Middle Name:MOHAMED
Last Name:AHMED
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:UNIVERSITY PEDIATRICIANS
Mailing Address - Street 2:4201 ST. ANTOINE UHC 5D MAILBOX# 226
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2153
Mailing Address - Country:US
Mailing Address - Phone:313-745-4405
Mailing Address - Fax:313-966-0665
Practice Address - Street 1:3901 BEAUBIEN
Practice Address - Street 2:CHILDREN'S HOSPITAL OF MI
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-966-5051
Practice Address - Fax:313-966-0665
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL1250527122080P0203X
MI43011016032080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine