Michael Mushtaq Ahmed, EDD.CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Flagstaff, AZ

NPI 1023201456 · NPPES record last updated Aug 20, 2007

Key facts

NPI
1023201456
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SLP5478 (AZ)
Practice address
8560 La Mancha LN
Flagstaff, AZ 86004-3287
Phone
(928) 526-0034
NPI assigned
Aug 20, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SLP5478AZMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP5478 AZ Yes

Addresses

Primary practice location

8560 La Mancha LN
Flagstaff, AZ 86004-3287

Mailing address

8560 La Mancha LN
Flagstaff, AZ 86004-3287
Phone (928) 526-0034

Other providers in Flagstaff, AZ

All providers in Flagstaff, AZ · Speech-Language Pathologist in Arizona

Sources for this page

Verify at the official NPI Registry.