Individual
DR. REDAH Z MAHMOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
120 STONEBRIDGE PKWY STE 110, WOODSTOCK, GA 30189-3768
(678) 324-4444
(678) 324-4405
Mailing address
55 WHITCHER ST NE STE 350, MARIETTA, GA 30060-1129
(470) 956-9639
(678) 819-0357
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301093085
MI
207R00000X
Internal Medicine Physician
4301093085
MI
207RC0000X
Cardiovascular Disease Physician
Primary
81668
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12330056
CAQH
—
05
—
1609030394
—
MI
Enumeration date
07/11/2008
Last updated
10/07/2019
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