Individual
MAHNAZ AHMAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1321 NE 99TH AVE, STE 200, PORTLAND, OR 97220-9436
(503) 215-4250
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD23002
OR
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
MD23002
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218491
—
OR
01
—
P01010657
RR MEDICARE
OR
Enumeration date
07/18/2006
Last updated
02/10/2022
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