MEDICARE: DR. FADEEL HASSAN MAHMOOD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital	4301096892	MI
2	208100000X	Physical Medicine & Rehabilitation Physician	35120979	OH

General Provider Information

NPI Number	:	1275847063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FADEEL HASSAN MAHMOOD M.D.

Provider Business Mailing Address
First Line	:	20800 HARVARD RD
Second Line	:	2ND FLOOR
City	:	HIGHLAND HILLS
State	:	OH
Zip	:	44122-7249
Country	:	US
Telephone Number	:	216-383-0100
Fax Number	:

Provider Business Practice Location Address
First Line	:	4480 RICHMOND RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-5777
Country	:	US
Telephone Number	:	216-765-2840
Fax Number	:	216-765-2841

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2010
Last Update Date	:	10/05/2015

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