Organization
AMTUL R AHMAD MD SC
Active
Other names
Amtul R Ahmad MD SC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMTUL REHMAN AHMAD MD (PRESIDENT/OWNER)
(262) 564-0611
Entity
Organization
Contact information
Practice address
3601 30TH AVE, SUITE #101, KENOSHA, WI 53144-1695
(262) 564-0611
(262) 564-0601
Mailing address
3601 30TH AVE, SUITE #101, KENOSHA, WI 53144-1695
(262) 564-0611
(262) 564-0601
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
40006020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32466300
—
WI
Enumeration date
09/29/2006
Last updated
03/07/2023
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