Provider Demographics
NPI:1679794770
Name:MAHMUD, ANEELA (MD)
Entity Type:Individual
Prefix:MISS
First Name:ANEELA
Middle Name:
Last Name:MAHMUD
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 1:2610 WHIPPET WAY
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5236
Mailing Address - Country:US
Mailing Address - Phone:928-554-1052
Mailing Address - Fax:928-554-1053
Practice Address - Street 1:5701 W TALAVI BLVD STE 110
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-1887
Practice Address - Country:US
Practice Address - Phone:602-843-1313
Practice Address - Fax:602-843-1313
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-050519207R00000X
MDD0072642207R00000X
AZ52508207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine