Provider Demographics
NPI:1730986936
Name:AHMED, UBAH M
Entity type:Individual
Prefix:MS
First Name:UBAH
Middle Name:M
Last Name:AHMED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7768 HAMPTON PL STE 1B
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-6770
Mailing Address - Country:US
Mailing Address - Phone:856-803-3824
Mailing Address - Fax:678-528-0297
Practice Address - Street 1:7768 HAMPTON PL STE 1B
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-6770
Practice Address - Country:US
Practice Address - Phone:856-803-3824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0030089834376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide