Provider Demographics
NPI:1871797746
Name:AHMAD, JAMIL (MD)
Entity type:Individual
Prefix:DR
First Name:JAMIL
Middle Name:
Last Name:AHMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 GEORGE STREET, APT. S-512
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L4Y2K6
Mailing Address - Country:CA
Mailing Address - Phone:647-239-7710
Mailing Address - Fax:
Practice Address - Street 1:THE PLASTIC SURGERY CLINIC
Practice Address - Street 2:1421 HURONTARIO STREET
Practice Address - City:MISSISSAUGA
Practice Address - State:ONTARIO
Practice Address - Zip Code:L5G3H5
Practice Address - Country:CA
Practice Address - Phone:905-278-7077
Practice Address - Fax:905-275-1582
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ92860208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP1-0022860OtherINSTITUTIONAL PERMIT