Provider Demographics
NPI:1477739506
Name:MAHMOOD, TASLIMA (MD)
Entity Type:Individual
Prefix:
First Name:TASLIMA
Middle Name:
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 1:43 TOWNSHIP ROAD 1525
Mailing Address - Street 2:
Mailing Address - City:PROCTORVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45669-8056
Mailing Address - Country:US
Mailing Address - Phone:740-886-1780
Mailing Address - Fax:
Practice Address - Street 1:43 TOWNSHIP ROAD 1525
Practice Address - Street 2:
Practice Address - City:PROCTORVILLE
Practice Address - State:OH
Practice Address - Zip Code:45669-8056
Practice Address - Country:US
Practice Address - Phone:740-886-1780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY246983207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine