Provider Demographics
NPI:1316997398
Name:MAHMOOD, MUBASHIR (MD)
Entity type:Individual
Prefix:
First Name:MUBASHIR
Middle Name:
Last Name:MAHMOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9303 PARK WEST BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4304
Mailing Address - Country:US
Mailing Address - Phone:865-951-0083
Mailing Address - Fax:865-985-0901
Practice Address - Street 1:9303 PARK WEST BLVD STE 100
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4304
Practice Address - Country:US
Practice Address - Phone:865-951-0083
Practice Address - Fax:865-951-0083
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD33965207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3853098Medicaid
G94452Medicare UPIN
TNG94452Medicare UPIN
TN3853098Medicaid