Individual
MAHMOOD A KHALID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
461 W HURON ST, PONTIAC, MI 48341-1601
(248) 857-7515
(248) 857-7524
Mailing address
PO BOX 77000, DEPT 160901, DETROIT, MI 48277-1609
(248) 857-7515
(734) 677-7407
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
035499
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E01133
BCBS OF MI GROUP
MI
05
—
2707671
—
MI
05
—
4626456
—
MI
01
—
CI8050
MEDICARE RR GROUP
MI
Enumeration date
07/17/2006
Last updated
03/15/2011
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