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General NPI Number Information
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NPI Number | 1639238629
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Entity Type | Organization
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Legal Business Name | K MAHMOOD M D INC
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 12/18/2008
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Provider Practice Location Address
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Address Line | 960 W WOOSTER ST SUITE 202
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City | BOWLING GREEN
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State | OH
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Zip | 43402-2644
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Country | US
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Telephone | 419-353-1819
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Fax | 419-353-8364
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Provider Business Mailing Address
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Address Line | 960 W WOOSTER ST SUITE 202
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City | BOWLING GREEN
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State | OH
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Zip | 43402-2644
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Country | US
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Telephone | 419-353-1819
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Fax | 419-353-8364
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Authorized Official
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Title or Position | OWNER
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Name | KHALID MAHMOOD
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Credential | M.D.
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Telephone | 419-353-1819
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State | OH
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