Provider Demographics
NPI:1528133188
Name:AHMAD, NASIR (MD)
Entity type:Individual
Prefix:
First Name:NASIR
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 1:1128 S LINDEN RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3410
Mailing Address - Country:US
Mailing Address - Phone:810-230-0383
Mailing Address - Fax:810-230-0035
Practice Address - Street 1:1128 S LINDEN RD
Practice Address - Street 2:SUITE 10
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3410
Practice Address - Country:US
Practice Address - Phone:810-230-0383
Practice Address - Fax:810-230-0035
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301037454207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
19006OtherGREAT LAKES HEALTH PLAN
204004OtherMCLAREN HEALTH PLAN
383124270100OtherCOMMUNITY CHOICE OF MI
0402503271OtherBLUE CARE NETWORK
0403271OtherHEALTH PLUS OF MICHIGAN
204004OtherMCLAREN HEALTH ADVANTAGE
2955722OtherMICHIGAN DEPARTMENT
0402503271OtherFEDERAL BCBS
B43317OtherHEALTH ALLIANCE PLAN
0402503271OtherBLUE CROSS BLUE SHIELD O
100157OtherGREAT LAKES HEALTH PLAN
NA037454OtherSTATE LICENSE NUMBER
1779158002OtherCIGNA HEALTHCARE
MI2955722Medicaid
C247BOtherMCARE
100157OtherGREAT LAKES HEALTH PLAN
0250327Medicare ID - Type Unspecified