Basic Information
| Provider Information | |||||||||
| NPI: | 1124447255 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AHMAD | ||||||||
| FirstName: | MEDIHA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 529 S. JACKSON ST. | ||||||||
| Address2: | STE 400 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 40202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025612703 | ||||||||
| FaxNumber: | 5025612709 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 BAYLOR PLZ | ||||||||
| Address2: | SURGERY EDUCATION OFFICE, SUITE 404D | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770303411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137988941 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2014 | ||||||||
| LastUpdateDate: | 11/05/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | R3406 | KY | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
No ID Information.