Provider Demographics
NPI:1528462009
Name:MAHMOUD, SAYED
Entity type:Individual
Prefix:
First Name:SAYED
Middle Name:
Last Name:MAHMOUD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22199-0100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 100
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22199-0100
Practice Address - Country:US
Practice Address - Phone:703-592-6861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-13
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022130541835P0200X, 1835G0303X, 1835N1003X, 1835X0200X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P0200XPharmacy Service ProvidersPharmacistPediatrics
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835N1003XPharmacy Service ProvidersPharmacistNutrition Support
No1835X0200XPharmacy Service ProvidersPharmacistOncology