Organization
RAPID RESPONSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SIRAJ K AHMED M.D. (PRESIDENT)
(219) 878-5864
Entity
Organization
Contact information
Practice address
10176 W 400 N, SUITE D, MICHIGAN CITY, IN 46360-9009
(219) 878-5864
(219) 878-0632
Mailing address
10176 W 400 N, SUITE B, MICHIGAN CITY, IN 46360-9009
(219) 878-5864
(219) 878-0632
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01041335
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
01041335
IN
207RP1001X
Pulmonary Disease Physician
01041335
IN
208D00000X
General Practice Physician
Primary
01041335
IN
Other
Enumeration date
04/18/2011
Last updated
04/18/2011
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