Provider Demographics
NPI:1659948024
Name:AHMAD, IJAZ (DPM)
Entity type:Individual
Prefix:
First Name:IJAZ
Middle Name:
Last Name:AHMAD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 STANHOPE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-4434
Mailing Address - Country:US
Mailing Address - Phone:215-252-6678
Mailing Address - Fax:
Practice Address - Street 1:20 CROSSROADS DR STE 15
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5479
Practice Address - Country:US
Practice Address - Phone:410-363-4343
Practice Address - Fax:410-356-6373
Is Sole Proprietor?:No
Enumeration Date:2021-06-05
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01786213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery