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Individual

DR. SAFIQUE AHMED

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
77 HOSPITAL DR STE 301, LOGAN, WV 25601-3451
(304) 792-1132
(304) 792-1133
Mailing address
PO BOX 58176, CHARLESTON, WV 25358-0176
(304) 792-1132
(304) 792-1133

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
20171
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1801195001
WV
01
64017122
KENTUCKY MEDICAID
WV
Enumeration date
06/29/2006
Last updated
01/30/2024
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