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NPI Code Detail

MEDICARE: DR. ALI H MAHMOOD MD

MEDICARE:  DR. ALI H MAHMOOD  MD
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
1207R00000XInternal Medicine PhysicianAM056507MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11108212991OTHERMIBCBS PIN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386643013
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALI H MAHMOOD MD
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 : 313-893-5495
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 :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2005
Last Update Date : 11/07/2024

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Directions to “ DR. ALI H MAHMOOD MD” Practice Location

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