Healthcare Provider Details

I. General information

NPI: 1235707324
Provider Name (Legal Business Name): AYED MAHMOUD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 ST. ANTOINE BLVD. 9C, UHC DETROIT, MI 48201
DETROIT MI
48201
US

IV. Provider business mailing address

4201 ST. ANTOINE BLVD 9C, UHC
DETROIT MI
48201
US

V. Phone/Fax

Practice location:
  • Phone: 313-993-8112
  • Fax:
Mailing address:
  • Phone: 443-858-7412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: