Organization
GREENVILLE NEUROLOGY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD A AHMED M.D. (OWNER)
(662) 332-9872
Entity
Organization
Contact information
Practice address
1502 S COLORADO ST, GREENVILLE, MS 38703-7219
(662) 332-9872
(662) 332-9878
Mailing address
1502 S COLORADO ST, GREENVILLE, MS 38703-7219
(662) 332-9872
(662) 332-9878
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
16065
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119831
—
MS
01
—
512I130029
MEDICARE PART B
MS
Enumeration date
04/19/2012
Last updated
04/19/2012
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