Provider Demographics
NPI:1437118197
Name:MUSTAFA, MAHMOUD H (MD)
Entity Type:Individual
Prefix:DR
First Name:MAHMOUD
Middle Name:H
Last Name:MUSTAFA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MAHMOUD
Other - Middle Name:H
Other - Last Name:MUSTAFA, MD, FACP, PC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2311 M ST NW
Mailing Address - Street 2:SUITE 401
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1445
Mailing Address - Country:US
Mailing Address - Phone:202-331-3338
Mailing Address - Fax:202-223-9130
Practice Address - Street 1:2311 M ST NW
Practice Address - Street 2:SUITE 401
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1445
Practice Address - Country:US
Practice Address - Phone:202-331-3338
Practice Address - Fax:202-223-9130
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD15650207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCB93274Medicare UPIN
DCG01537M01Medicare ID - Type Unspecified