Provider Demographics
NPI:1497916670
Name:TOURKY, MOHAMED MAHMOUD (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:MAHMOUD
Last Name:TOURKY
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 1:6934 AVIATION BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-2593
Mailing Address - Country:US
Mailing Address - Phone:443-949-0814
Mailing Address - Fax:443-949-0825
Practice Address - Street 1:6934 AVIATION BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-2593
Practice Address - Country:US
Practice Address - Phone:443-949-0814
Practice Address - Fax:443-949-0825
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD69247208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3987962OtherCIGNA
WV12697373OtherPHCS/MULTIPLAN
WV3810013250Medicaid
KY7100066940Medicaid
WV1073922OtherBRICKSTREET
WV3987962OtherCIGNA
WV12697373OtherPHCS/MULTIPLAN