Mahmood, Fayyaz
Mahmood, Fayyaz is an individual health care provider with primary practice located at 24988 Se Stark St Ste 300, Gresham OR 97030-8322. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Mahmood, Fayyaz can be contacted via phone (503) 674-5818.Contact Information
Primary practice address
24988 Se Stark St Ste 300
Gresham OR 97030-8322
Phone: (503) 674-5818
Fax: (503) 674-6709
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD16510 | Oregon |
Profile Details
| NPI number | 1790777050 |
|---|---|
| LBN Legal business name | Mahmood, Fayyaz |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 22nd, 2005 |
| Last updated | Nov 17th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790777050 | NPPES |
| Oregon | MEDICAID | 010020 |
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