Healthcare Provider Details

I. General information

NPI: 1003170739
Provider Name (Legal Business Name): AIMAN M MAHMOOD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2012
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5877 LIVERNOIS RD STE 105
TROY MI
48098-3100
US

IV. Provider business mailing address

5877 LIVERNOIS RD STE 105
TROY MI
48098-3100
US

V. Phone/Fax

Practice location:
  • Phone: 248-550-0525
  • Fax:
Mailing address:
  • Phone: 248-550-0525
  • Fax: 947-221-2114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301100066
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: