Ahmed Family Practice Llc | |
528 Forest Pkwy Ste A Forest Park GA 30297-6109 | |
(404) 968-9469 | |
Not Available |
Full Name | Ahmed Family Practice Llc |
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Speciality | Family Medicine |
Location | 528 Forest Pkwy, Forest Park, Georgia |
Authorized Official Name and Position | Kashif Ahmed (OWNER) |
Authorized Official Contact | 4049689469 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ahmed Family Practice Llc 528 Forest Pkwy Ste A Forest Park GA 30297-6109 Ph: (404) 968-9469 | Ahmed Family Practice Llc 528 Forest Pkwy Ste A Forest Park GA 30297-6109 Ph: (404) 968-9469 |
NPI Number | 1831579812 |
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Provider Enumeration Date | 06/04/2015 |
Last Update Date | 01/28/2016 |
Medicare PECOS PAC ID | 6305159930 |
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Medicare Enrollment ID | O20150724011591 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831579812 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Kashif Ahmed |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1023227030 PECOS PAC ID: 1456411024 Enrollment ID: I20081201000161 |
Provider Name | Ashley Blackmon |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306107685 PECOS PAC ID: 0547418592 Enrollment ID: I20120917000177 |
Provider Name | Diana Carmichael |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477054260 PECOS PAC ID: 0648528653 Enrollment ID: I20180808001488 |
Provider Name | Uwa Amoji |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265910608 PECOS PAC ID: 0345574299 Enrollment ID: I20190626001237 |
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