Individual
SHABAN MAHMOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1330 COSHOCTON AVE, MOUNT VERNON, OH 43050-1440
(740) 393-9000
Mailing address
1330 COSHOCTON AVE, MOUNT VERNON, OH 43050-1440
(740) 393-9000
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
74977
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000207469
ANTHEM
—
05
—
2083632
—
OH
Enumeration date
09/06/2005
Last updated
03/25/2009
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