Healthcare Provider Details

I. General information

NPI: 1558132803
Provider Name (Legal Business Name): ASAAD MAHMOUD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 N MAIN ST FL 5
ATTLEBORO MA
02703-2282
US

IV. Provider business mailing address

8 N MAIN ST FL 5
ATTLEBORO MA
02703-2282
US

V. Phone/Fax

Practice location:
  • Phone: 508-409-9000
  • Fax: 508-492-2964
Mailing address:
  • Phone: 508-409-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN10009485
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: