Provider Demographics
NPI:1730277559
Name:WASIM AHMED MD LLC
Entity type:Organization
Organization Name:WASIM AHMED MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WASIM
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-856-7055
Mailing Address - Street 1:29 E NORTH ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-3724
Mailing Address - Country:US
Mailing Address - Phone:724-856-7055
Mailing Address - Fax:724-856-7034
Practice Address - Street 1:29 E NORTH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-3724
Practice Address - Country:US
Practice Address - Phone:724-856-7055
Practice Address - Fax:724-856-7034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-072044-L207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101453952001Medicaid
PA1780018OtherBCBS PA HIGHMARK
PA1780018OtherBCBS PA HIGHMARK
PA097702Medicare PIN
PAP00089367Medicare PIN