Individual
DR. FAHEEM AHMAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12750 ST FRANCIS DR STE 320, CROWN POINT, IN 46307-0264
(219) 662-0077
(219) 662-9496
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01074824A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
01074824A
IN
207RC0000X
Cardiovascular Disease Physician
036093882
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036093882
—
IL
01
—
1124399605
BCBS GROUP NUMBER
IL
05
—
201283500
—
IN
Enumeration date
11/14/2005
Last updated
01/12/2024
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