Organization
ANIS AHMAD, M.D., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANIS AHMAD M.D., F.R.C.P. (M.D)
(309) 762-6161
Entity
Organization
Contact information
Practice address
3061 7TH ST, STE A, MOLINE, IL 61265-5903
(309) 762-6161
(309) 762-5387
Mailing address
3061 7TH ST, STE A, MOLINE, IL 61265-5903
(309) 762-6161
(309) 762-5387
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036049910
IL
207RC0000X
Cardiovascular Disease Physician
036049910
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360499102
—
IL
01
—
111918028
RAILROAD MEDICARE PIN
IL
Enumeration date
05/16/2008
Last updated
03/25/2010
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