Dervish, Ahmet
Dervish, Ahmet is an individual health care provider with primary practice located at 2845 Greenbrier Rd Ste 340 , Green Bay WI 54311-6519. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Pain Medicine, which is considered as his primary health care specialty. Dervish, Ahmet can be contacted via phone (920) 288-8380.Contact Information
Primary practice address
2845 Greenbrier Rd Ste 340
Green Bay WI 54311-6519
Phone: (920) 288-8380
Fax: (920) 288-8385
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 33794 | Wisconsin |
Profile Details
| NPI number | 1104854462 |
|---|---|
| LBN Legal business name | Dervish, Ahmet |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2006 |
| Last updated | Aug 29th, 2008 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104854462 | NPPES |
| Michigan | MEDICAID | 104365449 | |
| Michigan | Other | 050080452 | |
| Michigan | MEDICAID | 32021400 |
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