Basic Information
Provider Information
NPI: 1811384027
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AHMAD
FirstName: ZOHAIB
MiddleName: YUSUF
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6201 GREENLEIGH AVE FL 2
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212202004
CountryCode: US
TelephoneNumber: 4109336421
FaxNumber:  
Practice Location
Address1: 600 N WOLFE ST
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212870005
CountryCode: US
TelephoneNumber: 4109555000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/25/2015
LastUpdateDate: 02/12/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/12/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202XD89333MDY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
D8933301MDLICENSEOTHER


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