Provider Demographics
NPI:1487848453
Name:AHMED, MUHAMMAD (MD)
Entity type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:
Last Name:AHMED
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 1:9555 76TH ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANT PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53158-1984
Mailing Address - Country:US
Mailing Address - Phone:262-656-2930
Mailing Address - Fax:262-656-2749
Practice Address - Street 1:9697 SAINT CATHERINES DR # 400
Practice Address - Street 2:
Practice Address - City:PLEASANT PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53158-2118
Practice Address - Country:US
Practice Address - Phone:262-577-8300
Practice Address - Fax:262-656-3481
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-124679207Q00000X
WI71821-20207Q00000X
NV14788207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1487848453OtherBCBSWI
WI1487848453Medicaid
WIAHMEDMU2OtherMERCYCARE INSURANCE
ILF400398944-214660OtherIL MEDICARE
WIAHMEDMU2OtherMERCYCARE INSURANCE
WI1487848453OtherBCBSWI