Imtiaz Ahmad, MD, MBBS
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · North Little Rock, AR
NPI 1245078153 · NPPES record last updated Jul 16, 2024
Key facts
- NPI
- 1245078153
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 3201 Springhill Dr Ste 100
North Little Rock, AR 72117-2905 - Phone
- (501) 955-4530
- NPI assigned
- Jul 16, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240730003925 | AR | Order and Referring Only - Internal Medicine |
2466999156 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
3201 Springhill Dr Ste 100
North Little Rock, AR 72117-2905
Mailing address
3201 Springhill Dr Ste 100
North Little Rock, AR 72117-2905
Phone (718) 938-7253
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- Kelsey Agre
- Holly Agud
- Aizaz Ahmad
- Olivia Kay Ragni Ahrendsen
- Nayab Ahsan
- Grace Glass Aikman
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- Christopher Akins Sr.
All providers in North Little Rock, AR · Student in an Organized Health Care Education/Training Program in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.