Individual
MAHMOOD A AHMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
35 - 57 HARRISON ST, JOHNSON CITY, NY 13790
(607) 763-6622
(607) 763-5064
Mailing address
33 LEWIS RD, 2ND FLOOR, BINGHAMTON, NY 13905-1048
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
230320
NY
208M00000X
Hospitalist Physician
Primary
230320
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001867572
PENNSYLVANIA MEDICAID
NY
05
—
02371566
—
NY
Enumeration date
12/05/2005
Last updated
01/04/2017
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