Individual
AHMED MOURTADA AL QADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MBBCH
Contact information
Practice address
2525 W UNIVERSITY AVE, MUNCIE, IN 47303-3421
(765) 747-4306
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01091664A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1103716593
ANTHEM PTAN
IN
05
—
300050119
—
IN
01
—
M122404079
MEDICARE PTAN
IN
Enumeration date
04/01/2021
Last updated
05/15/2024
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