Provider Demographics
NPI:1225088560
Name:MAHMOOD, MUNEERA ASAD (MD)
Entity Type:Individual
Prefix:DR
First Name:MUNEERA
Middle Name:ASAD
Last Name:MAHMOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10056 OAKLEY CT
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22181-5354
Mailing Address - Country:US
Mailing Address - Phone:804-675-5000
Mailing Address - Fax:804-675-5908
Practice Address - Street 1:1201 BROAD ROCK BLVD
Practice Address - Street 2:MCGUIRE VA MEDICAL CENTER , EYE CLINIC (112)
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23249-0001
Practice Address - Country:US
Practice Address - Phone:804-675-5541
Practice Address - Fax:804-675-5908
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101048777207W00000X
DCMD32958207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCC62819Medicare UPIN