Individual
AHSAN MAHMOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1720 BEACON ST, FORT WAYNE, IN 46805-4749
(260) 373-8000
(260) 373-8034
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01067441A
IN
2084P0800X
Psychiatry Physician
252808
NY
2084P0802X
Addiction Psychiatry Physician
01067441A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02649190
—
NY
05
—
201023350
—
IN
05
—
300012812
—
IN
Enumeration date
02/27/2006
Last updated
10/14/2022
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