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General NPI Number Information
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NPI Number | 1679569222
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Entity Type | Individual
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Provider Name | MAHMOUD S MOHAMED M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 02/06/2009
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Provider Practice Location Address
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Address Line | 4417 N HOLLAND SYLVANIA RD SUITE 301C
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City | TOLEDO
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State | OH
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Zip | 43623-3518
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Country | US
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Telephone | 419-517-5333
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Fax | 419-517-5333
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Provider Business Mailing Address
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Address Line | 4417 N HOLLAND SYLVANIA RD SUITE 301C
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City | TOLEDO
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State | OH
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Zip | 43623-3518
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Country | US
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Telephone | 419-517-5333
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Fax | 419-517-5333
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4301072814
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 35083960
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License Number State | OH
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