Provider Demographics
NPI:1902151301
Name:AHMAD, MUNEER (MD)
Entity Type:Individual
Prefix:
First Name:MUNEER
Middle Name:
Last Name:AHMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 PAWTUCKET BLVD
Mailing Address - Street 2:UNIT 706
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-2038
Mailing Address - Country:US
Mailing Address - Phone:313-506-5253
Mailing Address - Fax:
Practice Address - Street 1:47 HIGH STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-2153
Practice Address - Country:US
Practice Address - Phone:978-258-9672
Practice Address - Fax:866-722-5233
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA263018208M00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program