Individual
MOHAMMAD FAZLE AHMAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1348 WALTON WAY STE 5100, AUGUSTA, GA 30901-5108
(706) 724-8611
Mailing address
1348 WALTON WAY STE 5100, AUGUSTA, GA 30901-5108
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
104040
GA
207R00000X
Internal Medicine Physician
OS18382
FL
207RC0000X
Cardiovascular Disease Physician
Primary
104040
GA
Other
Enumeration date
03/28/2019
Last updated
07/31/2025
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