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Individual

SHAHID MAHMOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
46 JACKSON DR, CRANFORD, NJ 07016-3504
(908) 272-0699
(908) 272-1478
Mailing address
11 ELLINGTON PL, ENGLEWOOD CLIFFS, NJ 07632-2014
(201) 951-7233
(201) 816-9431

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA05915400
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100070
AMERIGROUP #
NJ
01
2747293000
AMERIHEALTH #
NJ
05
7803401
NJ
Enumeration date
07/19/2006
Last updated
09/28/2007
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