Organization
ADVANCED PAIN AND REHAB CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHMED MAHMOUD MD (OWNER)
(508) 414-1464
Entity
Organization
Contact information
Practice address
527 MEDICAL PARK DR, SUITE 103, BRIDGEPORT, WV 26330-9008
(508) 414-1464
Mailing address
527 MEDICAL PARK DR, SUITE 103, BRIDGEPORT, WV 26330-9008
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
12/01/2011
Last updated
12/01/2011
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