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NPI Code Detail

MEDICARE: ALI HASAN MAHMOOD MD PLC

MEDICARE: ALI HASAN MAHMOOD MD PLC
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
1207Q00000XFamily Medicine PhysicianGP068359MI
2207R00000XInternal Medicine PhysicianAM056507MI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5DA2203OTHERMIRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2615861800OTHERMIDEPT OF LABOR
3700H215230OTHERMIBC
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6700H215230OTHERMIBCN

General Provider Information

NPI Number : 1275532905
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALI HASAN MAHMOOD MD PLC
Provider Business Mailing Address
First Line : 13031 CONANT ST
Second Line :
City : DETROIT
State : MI
Zip : 48212-2361
Country : US
Telephone Number : 313-893-5490
Fax Number : 313-561-0277
Provider Business Practice Location Address
First Line : 13031 CONANT ST
Second Line :
City : DETROIT
State : MI
Zip : 48212-2361
Country : US
Telephone Number : 313-893-5490
Fax Number : 313-893-5495
Authorized Official
Title or Position : OWNER/PHYSICIAN
Name : DR. ALI H MAHMOOD
Credential : MD
Telephone Number : 313-893-5490
Provider Enumeration Date : 07/15/2005
Last Update Date : 11/07/2024

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1790014819 — MINAL PHARMACY LLC
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1023778552 — MRS. AMNA IMAD MOHAMMAD RPH
Practice Location Address:
13031 CONANT ST
DETROIT, MI
48212-2361
Practice Phone: 313-893-3339
Practice Fax: 313-893-3337

Directions to “ALI HASAN MAHMOOD MD PLC ” Practice Location

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