Individual provider Active NPI

Ahmad Walid Naseri, MD

  • Internal Medicine Physician
  • Snellville, GA
National Provider Identifier
1558064436
Registry record updated Aug 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
112302 Issued in GA
Practice address
1700 Medical Way
Snellville, GA 30078-2195
Phone
(770) 979-0200
NPI assigned
Mar 22, 2023
Last updated
Aug 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 112302 GA Primary

Addresses

Primary practice location

1700 Medical Way
Snellville, GA 30078-2195

Mailing address

1700 Medical Way
Snellville, GA 30078-2195
Phone (770) 979-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230525003513 GA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2860858354

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
112302GAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786752000000",
    "number": "1558064436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 MEDICAL WAY",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782195",
            "telephone_number": "770-979-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 MEDICAL WAY",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782195",
            "telephone_number": "770-979-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASERI",
        "first_name": "AHMAD WALID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-22",
        "last_updated": "2026-08-15",
        "certification_date": "2026-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "112302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.