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Individual

HANI AHMAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1720 BEACON ST, FORT WAYNE, IN 46805-4749
(260) 373-8000
(260) 373-8034
Mailing address
15024 REMINGTON PL, FORT WAYNE, IN 46814-7599
(317) 437-8061
(727) 877-5302

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01060341A
IN
2084P0800X
Psychiatry Physician
ME111572
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200825450
IN
Enumeration date
06/23/2006
Last updated
05/11/2023
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