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Individual

DR. AHMAD S AHMADZAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6924 INDIANAPOLIS BOULEVARD, HAMMOND, IN 46324-2206
(219) 844-9060
(219) 844-6912
Mailing address
9660 WICKER AVE, ST JOHN, IN 46373-9487
(219) 226-2203
(219) 226-2202

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01032690
IN
207R00000X
Internal Medicine Physician
Primary
01032690A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100169490
IN
Enumeration date
11/04/2005
Last updated
07/09/2010
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