# MTH CLINIC PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558354522
- **Authorized official:** DR. FAYYAZ MAHMOOD MD (CEO)
- **Authorized official phone:** (503) 674-5818

## Contact information

- **Practice address:** 24988 SE STARK ST, STE 300, GRESHAM, OR 97030-8322
- **Practice address phone:** (503) 674-5818
- **Practice address fax:** (503) 674-6709
- **Mailing address:** 24988 SE STARK ST, STE 300, GRESHAM, OR 97030-8322
- **Mailing address phone:** (503) 674-5818
- **Mailing address fax:** (503) 674-6709

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | OR | Yes |

## Other

- **Enumeration date:** 08/25/2005
- **Last updated:** 07/21/2022