Provider Demographics
NPI:1437537354
Name:ALBAHHAR, MAHMOOD (MD)
Entity Type:Individual
Prefix:
First Name:MAHMOOD
Middle Name:
Last Name:ALBAHHAR
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 1:4245 ROOSEVELT WAY NE BOX 354755
Mailing Address - Street 2:UNIVERSITY OF WASHINGTON MEDICAL CENTER
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105
Mailing Address - Country:US
Mailing Address - Phone:206-598-6868
Mailing Address - Fax:206-598-2847
Practice Address - Street 1:4245 ROOSEVELT WAY NE BOX 354755
Practice Address - Street 2:UNIVERSITY OF WASHINGTON MEDICAL CENTER
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105
Practice Address - Country:US
Practice Address - Phone:206-598-6868
Practice Address - Fax:206-598-2847
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2016-01-21
Deactivation Date:2015-12-21
Deactivation Code:
Reactivation Date:2016-01-19
Provider Licenses
StateLicense IDTaxonomies
WAFE604494922085R0202X, 2085R0203X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound