Provider Demographics
NPI:1013604685
Name:ASHKAR, MOHAMMAD AHMAD (DO)
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:AHMAD
Last Name:ASHKAR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 AIR CITY BLVD APT 313
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13441-4347
Mailing Address - Country:US
Mailing Address - Phone:315-447-7880
Mailing Address - Fax:
Practice Address - Street 1:169 AIR CITY BLVD APT 313
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13441-4347
Practice Address - Country:US
Practice Address - Phone:315-447-7880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ390200000X
NY330977208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program