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NPI Code Detail

MEDICARE: AMMAR MAHMOUD M.D

MEDICARE: AMMAR MAHMOUD M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician125063751IL
2207LP2900XPain Medicine (Anesthesiology) Physician85747-20WI
3207LP2900XPain Medicine (Anesthesiology) PhysicianMD21879ME

General Provider Information

NPI Number : 1235578485
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMMAR MAHMOUD M.D
Provider Business Mailing Address
First Line : 1716 LAWRENCE DR STE 103
Second Line :
City : DE PERE
State : WI
Zip : 54115-9108
Country : US
Telephone Number : 920-632-6800
Fax Number : 920-632-6806
Provider Business Practice Location Address
First Line : 1716 LAWRENCE DR STE 103
Second Line :
City : DE PERE
State : WI
Zip : 54115-9108
Country : US
Telephone Number : 920-632-6800
Fax Number : 920-632-6806
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2013
Last Update Date : 12/11/2025

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Directions to “ AMMAR MAHMOUD M.D” Practice Location

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