Organization Active NPI

Musaddeque Ahmad M.D. Inc.

  • Internal Medicine Physician
  • Festus, MO
National Provider Identifier
1497977805
Registry record updated Oct 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
107382 Issued in MO
Legal business name
MUSADDEQUE AHMAD M.D. INC.
Practice address
1390 Hwy 61 Ste 2100
Festus, MO 63028
Phone
(636) 933-6300
Fax
(636) 933-6406
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Musaddeque Ahmad, MDNPI 1093738742
Title
President
Phone
(636) 933-6300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 107382 MO Primary

Addresses

Primary practice location

1390 Hwy 61 Ste 2100
Festus, MO 63028

Mailing address

PO Box 69
Festus, MO 63028-0069
Phone (636) 933-6300

Other identifiers 1

IdentifierTypeStateIssuer
508208311MedicaidMO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540684800000",
    "number": "1497977805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630280069",
            "telephone_number": "636-933-6300",
            "fax_number": "636-933-6406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 HWY 61 STE 2100",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "63028",
            "telephone_number": "636-933-6300",
            "fax_number": "636-933-6406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSADDEQUE AHMAD M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2018-10-28",
        "status": "A",
        "authorized_official_last_name": "AHMAD",
        "authorized_official_first_name": "MUSADDEQUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-933-6300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "107382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "508208311",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.