MEDICARE: KHALID MAHMOUD

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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1821469693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHALID MAHMOUD

Provider Business Mailing Address
First Line	:	4330 E BAILS PL
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-4402
Country	:	US
Telephone Number	:	720-421-6589
Fax Number	:

Provider Business Practice Location Address
First Line	:	4330 E BAILS PL
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-4402
Country	:	US
Telephone Number	:	720-421-6589
Fax Number	:

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

Provider Enumeration Date	:	10/19/2015
Last Update Date	:	10/19/2015

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Directions to “ KHALID MAHMOUD ” Practice Location

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