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Individual

AMANDA AHMED

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
100 NAVARRE PL STE 6600, SOUTH BEND, IN 46601-1173
(574) 647-8800
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10004899A
IN
363A00000X
Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300118616
IN
Enumeration date
10/21/2024
Last updated
06/17/2026
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