Basic Information
| Provider Information | |||||||||
| NPI: | 1437396116 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AHMED | ||||||||
| FirstName: | ATIF | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11511 SHADOW CREEK PKWY | ||||||||
| Address2: | |||||||||
| City: | PEARLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775847298 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134424997 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3111 GUNDERSEN DR | ||||||||
| Address2: | |||||||||
| City: | ONALASKA | ||||||||
| State: | WI | ||||||||
| PostalCode: | 546508447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6087758100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2009 | ||||||||
| LastUpdateDate: | 01/20/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 65778 | WI | Y | Allopathic & Osteopathic Physicians | Dermatology | 207N00000X | T4301 | TX | N | Allopathic & Osteopathic Physicians | Dermatology | 207N00000X | 25532 | NE | N | Allopathic & Osteopathic Physicians | Dermatology | 207N00000X | 2013034091 | MO | N | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.