Provider Demographics
NPI:1194401398
Name:SHAH, SAYED MUSTAFA MAHMOOD (MBBS)
Entity type:Individual
Prefix:DR
First Name:SAYED MUSTAFA
Middle Name:MAHMOOD
Last Name:SHAH
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
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Mailing Address - Street 1:1 HOSPITAL DR # CE513
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65212-1000
Mailing Address - Country:US
Mailing Address - Phone:573-882-5092
Mailing Address - Fax:573-884-4249
Practice Address - Street 1:1 HOSPITAL DR # CE513
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-1000
Practice Address - Country:US
Practice Address - Phone:573-882-5092
Practice Address - Fax:573-884-4249
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO20230220852084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology