Healthcare Provider Details

I. General information

NPI: 1659505535
Provider Name (Legal Business Name): MUHAMMAD MAHMOOD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2009
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6540 WINTON RD
CINCINNATI OH
45224-1391
US

IV. Provider business mailing address

5400 FRANTZ RD SUITE 250
DUBLIN OH
43016-4144
US

V. Phone/Fax

Practice location:
  • Phone: 513-891-3636
  • Fax: 513-339-0790
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number35.126675
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number25757
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: