Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | LT000372 | PA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | LT000372 | PA |
NPI | 1346716412 |
---|---|
Provider Name | Karim Mahmoud Khamis Mahmoud |
First Address | Philadelphia, PA 19106-3500 |
Second Address | Philadelphia, PA 19107-6130 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2018 |
Last Update Date | 16/10/2018 |