Individual
KHAIRAT UDDIN AHMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 E PLEASANT ST, SPRINGFIELD, OH 45506-2201
(937) 328-5277
(937) 328-5276
Mailing address
651 S LIMESTONE ST, SPRINGFIELD, OH 45505-1965
(937) 328-5277
(937) 328-5276
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
35-03-7140A
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2007063
—
OH
Enumeration date
11/28/2006
Last updated
04/08/2008
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