Provider Demographics
NPI:1619972023
Name:MAHMOOD, SYED FARID (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:FARID
Last Name:MAHMOOD
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 1:2227 OLD EMMORTON RD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6187
Mailing Address - Country:US
Mailing Address - Phone:410-638-7791
Mailing Address - Fax:410-638-7796
Practice Address - Street 1:2227 OLD EMMORTON RD
Practice Address - Street 2:SUITE 212
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6189
Practice Address - Country:US
Practice Address - Phone:410-638-7791
Practice Address - Fax:410-638-7796
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00459210207R00000X
MDD45921174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF57632Medicare UPIN