Individual
MR. ILYAS AHMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
217 LAUREL HEIGHTS DRIVE, BRIDGETON, NJ 08302-3635
(856) 451-4150
(856) 451-2645
Mailing address
217 LAUREL HEIGHTS DRIVE, BRIDGETON, NJ 08302-3635
(856) 451-4150
(856) 451-2645
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA04681100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0274853001
AMERIHEALTH
NJ
05
—
3409805
—
NJ
01
—
4089916
AETNA
NJ
01
—
P505320
OXFORD
NJ
Enumeration date
07/31/2006
Last updated
11/29/2010
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