Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 20022 | WV |
NPI | 1861829947 |
---|---|
Provider Name | Mr. Hamada E Mahmoud |
First Address | Huntington, WV 25705-2058 |
Second Address | Huntington, WV 25705-2058 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2013 |
Last Update Date | 11/01/2017 |