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Individual

KHAWAJA R MAHMOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12 SAMMY MCGHEE BLVD, STE 102, JASPER, GA 30143-4093
(706) 253-9898
(706) 253-9896
Mailing address
12 SAMMY MCGHEE BLVD, STE 102, JASPER, GA 30143-4093
(706) 253-9898
(706) 253-9896

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
042648
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000721718U
GA
Enumeration date
09/08/2005
Last updated
02/14/2012
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