Provider Demographics
NPI:1871916031
Name:AHMAD, FARID A (MD)
Entity type:Individual
Prefix:DR
First Name:FARID
Middle Name:A
Last Name:AHMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8911 S RIDGE CROFT DR
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-3945
Mailing Address - Country:US
Mailing Address - Phone:414-350-0960
Mailing Address - Fax:
Practice Address - Street 1:2603 W RAWSON AVE
Practice Address - Street 2:127
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-8422
Practice Address - Country:US
Practice Address - Phone:414-539-4328
Practice Address - Fax:414-304-8496
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-23
Last Update Date:2021-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI61782-20207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine