Basic Information
| Provider Information | |||||||||
| NPI: | 1639221260 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AHMED | ||||||||
| FirstName: | OSMAN | ||||||||
| MiddleName: | I | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2191 9TH AVE N | ||||||||
| Address2: | |||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337137146 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278207778 | ||||||||
| FaxNumber: | 7278207779 | ||||||||
| Practice Location | |||||||||
| Address1: | 2191 9TH AVE N | ||||||||
| Address2: | |||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337137146 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278207778 | ||||||||
| FaxNumber: | 7278207779 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2007 | ||||||||
| LastUpdateDate: | 08/16/2016 | ||||||||
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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 | 207Q00000X | ME 59458 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.