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 IDStateProvider typePAC IDDetails
I20240730003925 AR Order and Referring Only - Internal Medicine
Practitioner - Internal Medicine
2466999156

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in North Little Rock, AR

All providers in North Little Rock, AR · Student in an Organized Health Care Education/Training Program in Arkansas

Sources for this page

Verify at the official NPI Registry.