Individual
MASOOD AHMAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 205-4730
(517) 205-4701
Mailing address
6565 S YALE AVE, SUITE 209, TULSA, OK 74136-8327
(918) 392-5400
(918) 392-5399
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
28864
OK
2084P0800X
Psychiatry Physician
35692
TN
2084P0800X
Psychiatry Physician
4301073723
MI
208D00000X
General Practice Physician
0000035692
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366481905
—
MI
05
—
200435250A
—
OK
05
—
3816082
—
TN
Enumeration date
06/06/2006
Last updated
08/13/2020
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