Provider Demographics
NPI:1699330266
Name:MAHMOOD, ARSLAN (MD)
Entity type:Individual
Prefix:
First Name:ARSLAN
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 1:100 STATE ST APT 318
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-5492
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6071 W. OUTER DRIVE
Practice Address - Street 2:SINAI GRACE HOSPITAL, DEPARTMENT OF MEDICINE - 4 MAIN
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235
Practice Address - Country:US
Practice Address - Phone:313-966-7434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2024-01-03
Deactivation Date:2019-12-16
Deactivation Code:
Reactivation Date:2020-01-27
Provider Licenses
StateLicense IDTaxonomies
OH35.149755207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program