Ahmad, Shafique

Ahmad, Shafique is an individual health care provider with primary practice located at 3165 Myrtle Ave Suite 2, Granite City IL 62040-5012. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Ahmad, Shafique can be contacted via phone (618) 876-7500.

Contact Information

Primary practice address
3165 Myrtle Ave Suite 2 Granite City IL 62040-5012
Phone: (618) 876-7500
Fax: (618) 876-0807
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036048376 Illinois

Profile Details

NPI number 1700973229
LBN Legal business name Ahmad, Shafique
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2006
Last updated Jan 26th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700973229 NPPES
Illinois MEDICAID 036048376

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