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
| License | State | Type | Specialty |
|---|---|---|---|
| SLP5478 | AZ | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Flagstaff, AZ · Speech-Language Pathologist in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.