Tahamtan Ahmadi, MD

Individual provider Active NPI Hematology & Oncology Physician · Philadelphia, PA

NPI 1902090475 · NPPES record last updated Feb 25, 2008

Key facts

NPI
1902090475
Entity type
Individual (NPI type 1)
Primary specialty
Hematology & Oncology Physician 207RH0003X
License
MT191760 (PA)
Practice address
3400 Spruce St
1 Maloney
Philadelphia, PA 19104-4206
Phone
(215) 662-3681
NPI assigned
Aug 28, 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)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT191760PAMDHematology & Oncology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X MT191760 PA Yes

Addresses

Primary practice location

3400 Spruce St
1 Maloney
Philadelphia, PA 19104-4206

Mailing address

3400 Spruce St
1 Maloney
Philadelphia, PA 19104-4206
Phone (215) 662-3681

Other providers in Philadelphia, PA

All providers in Philadelphia, PA · Hematology & Oncology Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.