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NPI Code Detail

MEDICARE: DR. GEHAN WALID MAHMOUD MD

MEDICARE: DR. GEHAN WALID MAHMOUD 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 Physician335062NY

General Provider Information

NPI Number : 1548845399
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEHAN WALID MAHMOUD MD
Provider Business Mailing Address
First Line : 375 SEGUINE AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10309-3932
Country : US
Telephone Number : 718-226-6902
Fax Number :
Provider Business Practice Location Address
First Line : 475 SEAVIEW AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10305-3436
Country : US
Telephone Number : 717-226-6902
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2021
Last Update Date : 01/15/2026

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