Provider Demographics
NPI:1053002337
Name:AHMED, MUHAMMAD (BSC, OD)
Entity type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:BSC, OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 SEAGREEN LANE
Mailing Address - Street 2:
Mailing Address - City:CHESTERMERE
Mailing Address - State:ALBERTA
Mailing Address - Zip Code:T1X0E8
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8125 TIMBERLAKE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-2607
Practice Address - Country:US
Practice Address - Phone:434-237-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618003309152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist