Provider Demographics
NPI:1174510184
Name:MAHMOOD, SYED KHALID (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:KHALID
Last Name:MAHMOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2614 JENKS AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4311
Mailing Address - Country:US
Mailing Address - Phone:850-769-2996
Mailing Address - Fax:850-769-4665
Practice Address - Street 1:2614 JENKS AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4311
Practice Address - Country:US
Practice Address - Phone:850-769-2996
Practice Address - Fax:850-769-4665
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME42192207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL067617900Medicaid
FL067617900Medicaid
FL03610Medicare ID - Type Unspecified