Provider Demographics
NPI:1770501454
Name:MAHMOOD, TARIQ (MD)
Entity Type:Individual
Prefix:
First Name:TARIQ
Middle Name:
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 1:19 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-4458
Mailing Address - Country:US
Mailing Address - Phone:410-848-5450
Mailing Address - Fax:410-848-5451
Practice Address - Street 1:19 RIDGE RD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-4458
Practice Address - Country:US
Practice Address - Phone:410-848-5450
Practice Address - Fax:410-848-5451
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0043725207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine