| Anis Ahmad, M.d., S.c. | |
|
3061 7th St Ste A Moline IL 61265-5903 | |
| (309) 762-6161 | |
| (309) 762-5387 |
| Full Name | Anis Ahmad, M.d., S.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 3061 7th St, Moline, Illinois |
| Authorized Official Name and Position | Anis Ahmad (M.D) |
| Authorized Official Contact | 3097626161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anis Ahmad, M.d., S.c. 3061 7th St Ste A Moline IL 61265-5903 Ph: (309) 762-6161 | Anis Ahmad, M.d., S.c. 3061 7th St Ste A Moline IL 61265-5903 Ph: (309) 762-6161 |
| NPI Number | 1154588317 |
|---|---|
| Provider Enumeration Date | 05/16/2008 |
| Last Update Date | 03/25/2010 |
| Medicare PECOS PAC ID | 6901975556 |
|---|---|
| Medicare Enrollment ID | O20080521000895 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154588317 | NPI | - | NPPES |
| 0360499102 | Medicaid | IL | |
| 111918028 | Other | IL | RAILROAD MEDICARE PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036049910 (Illinois) | Primary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | 036049910 (Illinois) | Secondary |
| Provider Name | Anis Ahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174511661 PECOS PAC ID: 9335146141 Enrollment ID: I20061108000302 |
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