Individual
GIASUDDIN AHMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7950 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 435-7001
Mailing address
2391 OLD POST RD, NILES, MI 49120-4989
(269) 683-3898
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01051797A
IN
207P00000X
Emergency Medicine Physician
4301076791
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760407001
—
MI
05
—
200296500
—
IN
Enumeration date
07/13/2006
Last updated
06/04/2010
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