Individual
ENDASHAW MAHMUD OMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 S JACKSON ST, ACB BUILDING, 3RD FLOOR, LOUISVILLE, KY 40202-1622
(502) 852-1384
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0320
(502) 588-0326
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
45380
KY
207RG0100X
Gastroenterology Physician
Primary
45380
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201305190
—
IN
05
—
7100355500
—
KY
Enumeration date
05/07/2009
Last updated
02/14/2017
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