Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 4351044471 | MI |
NPI | 1043879323 |
---|---|
Provider Name | Dr. Ali Mohamed Mahmoud |
First Address | Detroit, MI 48214-2949 |
Second Address | Detroit, MI 48201-2153 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2019 |
Last Update Date | 10/06/2019 |