Basic Information
| Provider Information | |||||||||
| NPI: | 1508827593 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ATIA | ||||||||
| FirstName: | AHMED | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 907 SUMNER ST M201 | ||||||||
| Address2: | GUARDIAN ANESTHESIA INC | ||||||||
| City: | STOUGHTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02072 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7813442325 | ||||||||
| FaxNumber: | 7813418544 | ||||||||
| Practice Location | |||||||||
| Address1: | 907 SUMNER ST | ||||||||
| Address2: | M201 | ||||||||
| City: | STOUGHTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02072 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089417000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2006 | ||||||||
| LastUpdateDate: | 09/23/2015 | ||||||||
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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 | 207LP2900X | 216741 | MA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207LP2900X | MD11089 | RI | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 410922 | 01 | RI | BLUECHIP | OTHER | 611000600 | 01 | DOL | OTHER | AA30366 | 01 | MA | HPHC | OTHER | 30902 | 01 | RI | BCBS | OTHER | 7010560 | 05 | RI | MEDICAID | 8983845 | 01 | CIGNA | OTHER | AA47844 | 01 | MA | HPHC | OTHER | 464616 | 01 | MA | TUFTS | OTHER | 6110000600 | 01 | MA | DOL | OTHER | 67400 | 01 | MA | FALLON | OTHER | 7017564 | 01 | MA | AETNA | OTHER | 7017564 | 01 | AETNA | OTHER | J27035 | 01 | MA | BCBS | OTHER | 46416 | 01 | MA | TUFTS | OTHER | J27035 | 01 | BCBS | OTHER | 20270527002 | 01 | TRICARE | OTHER | AA47844 | 01 | HPHC | OTHER | 202010504 | 01 | UNITEDHEALTH | OTHER | 202705274 | 01 | UNITEDHEALTH | OTHER | 202705274 | 01 | GREAT WEST | OTHER | 2038251 | 05 | MA | MEDICAID | 97252802 | 01 | NETWORK HEALTH | OTHER | 31395 | 01 | RI | NEIGBORHOOD HEALTH | OTHER |