Healthcare Provider Details
I. General information
NPI: 1386026748
Provider Name (Legal Business Name): SYED NAZEER MAHMOOD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/22/2015
Last Update Date: 11/01/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
665 BAY ROAD, UNIT B
DOVER DE
19901-3562
US
IV. Provider business mailing address
640 S STATE ST # MC3055
DOVER DE
19901-3530
US
V. Phone/Fax
- Phone: 302-608-5306
- Fax: 302-608-8504
- Phone: 302-608-5306
- Fax: 302-608-8504
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | C1-0025308 |
| License Number State | DE |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | C1-0025308 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: