Individual
DR. KHAJA MOHAMMED AHSANUDDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
28725
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016P5
GROUP ID NUMBER WITH BCBS
NC
01
—
10439
INDIVIDUAL ID # WITH BCBS
NC
05
—
8910439
—
NC
Enumeration date
05/17/2006
Last updated
10/08/2009
Update your record
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