# ALI HASAN MAHMOOD MD PLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AM MEDICAL CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275532905
- **Authorized official:** DR. ALI H MAHMOOD MD (OWNER/PHYSICIAN)
- **Authorized official phone:** (313) 893-5490

## Contact information

- **Practice address:** 13031 CONANT ST, DETROIT, MI 48212-2361
- **Practice address phone:** (313) 893-5490
- **Practice address fax:** (313) 893-5495
- **Mailing address:** 13031 CONANT ST, DETROIT, MI 48212-2361
- **Mailing address phone:** (313) 893-5490
- **Mailing address fax:** (313) 561-0277

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | GP068359 | MI | — |
| 207R00000X | Internal Medicine Physician | AM056507 | MI | Yes |

## Other

- **Enumeration date:** 07/15/2005
- **Last updated:** 11/07/2024