Basic Information
| Provider Information | |||||||||
| NPI: | 1033254115 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AHMED | ||||||||
| FirstName: | KHALID | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23315 FITZGERALD RD | ||||||||
| Address2: | |||||||||
| City: | BOTHELL | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980218908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102944098 | ||||||||
| FaxNumber: | 4253543724 | ||||||||
| Practice Location | |||||||||
| Address1: | 2336 GODDARD PKWY | ||||||||
| Address2: | |||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218011126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103346961 | ||||||||
| FaxNumber: | 4103346960 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2007 | ||||||||
| LastUpdateDate: | 03/07/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | D0062544 | MD | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0804X | D0062544 | MD | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 522156095 | 01 | MD | VALUE OPTIONS | OTHER | 522156095 | 01 | MD | COMMERCIAL INSURANCE | OTHER | 522156095 | 01 | MD | UNITED BEHAVIORAL HEALTH | OTHER | 522156095 | 01 | MD | MAGELLAN | OTHER | R968 | 01 | MD | CAREFIRST BCBS-FEDERAL | OTHER | 298470900 | 05 | MD | MEDICAID | 522156095 | 01 | MD | NCPPO | OTHER | 522156095 | 01 | MD | AMERICAN PSYCH SYSTEM | OTHER | 609550001 | 05 | MD | MEDICAID | 609550002 | 05 | MD | MEDICAID | 522156095 | 01 | MD | CHAMPVA | OTHER | 866L | 01 | MD | MEDICARE | OTHER | 517251 | 01 | MD | UNITED HEALTH CARE | OTHER | 522156095 | 01 | MD | TRICARE | OTHER | 522156095 | 01 | MD | AETNA | OTHER | 609550004 | 05 | MD | MEDICAID | LM49EA | 01 | MD | CAREFIRST BCBS-LOCAL | OTHER |