Basic Information
| Provider Information | |||||||||
| NPI: | 1568881472 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AHMED | ||||||||
| FirstName: | SHIFAT | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3020 E CAMELBACK RD | ||||||||
| Address2: | STE 301 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850164418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022649100 | ||||||||
| FaxNumber: | 6022649101 | ||||||||
| Practice Location | |||||||||
| Address1: | 625 N 6TH ST | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850042155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6023445011 | ||||||||
| FaxNumber: | 6023440930 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2014 | ||||||||
| LastUpdateDate: | 08/16/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | R3986 | KY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 57133 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0100X | 57133 | AZ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.