Individual
DR. AHMAD M HOOSHMAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
915 SOUTHWEST BLVD, #E, JEFFERSON CITY, MO 65109-5014
(573) 634-4700
(573) 635-4003
Mailing address
915 SOUTHWEST BLVD, #E, JEFFERSON CITY, MO 65109-5014
(573) 634-4700
(573) 635-4003
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
R1B54
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000015436
MEDICARE GROUP
MO
05
—
201565512
—
MO
Enumeration date
12/20/2005
Last updated
06/22/2012
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