Provider Demographics
NPI:1861829947
Name:MAHMOUD, HAMADA E (MD)
Entity Type:Individual
Prefix:MR
First Name:HAMADA
Middle Name:E
Last Name:MAHMOUD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MAMADA (MISPELLED)
Other - Middle Name:
Other - Last Name:MAHMOUD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5505 US ROUTE 60 EAST
Mailing Address - Street 2:SUITE 175
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-2058
Mailing Address - Country:US
Mailing Address - Phone:304-948-6754
Mailing Address - Fax:304-948-6752
Practice Address - Street 1:5505 US ROUTE 60 EAST
Practice Address - Street 2:SUITE 175
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-2058
Practice Address - Country:US
Practice Address - Phone:304-948-6754
Practice Address - Fax:304-948-6752
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20022207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine