| Ali Hasan Mahmood Md Plc | |
|
13031 Conant St Detroit MI 48212-2361 | |
| (313) 893-5490 | |
| (313) 893-5495 |
| Full Name | Ali Hasan Mahmood Md Plc |
|---|---|
| Speciality | Internal Medicine |
| Location | 13031 Conant St, Detroit, Michigan |
| Authorized Official Name and Position | Ali H Mahmood (OWNER/PHYSICIAN) |
| Authorized Official Contact | 3138935490 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ali Hasan Mahmood Md Plc 13031 Conant St Detroit MI 48212-2361 Ph: (313) 893-5490 | Ali Hasan Mahmood Md Plc 13031 Conant St Detroit MI 48212-2361 Ph: (313) 893-5490 |
| NPI Number | 1275532905 |
|---|---|
| Provider Enumeration Date | 07/15/2005 |
| Last Update Date | 11/07/2024 |
| Medicare PECOS PAC ID | 0840254017 |
|---|---|
| Medicare Enrollment ID | O20041117000378 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275532905 | NPI | - | NPPES |
| 1275532905 | Medicaid | MI | |
| 615861800 | Other | MI | DEPT OF LABOR |
| 700H215230 | Other | MI | BC |
| 4283129 | Medicaid | MI | |
| DA2203 | Other | MI | RAILROAD MEDICARE |
| 700H215230 | Other | MI | BCN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | GP068359 (Michigan) | Secondary |
| 207R00000X | Internal Medicine | AM056507 (Michigan) | Primary |
| Provider Name | Ali H Mahmood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386643013 PECOS PAC ID: 7517921786 Enrollment ID: I20041117000432 |
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