Provider Demographics
NPI:1972568103
Name:SFM, INC
Entity Type:Organization
Organization Name:SFM, INC
Other - Org Name:SAID F. MAHMOUD, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAID
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHMOUD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-484-2609
Mailing Address - Street 1:PO BOX 844458
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0458
Mailing Address - Country:US
Mailing Address - Phone:913-322-8859
Mailing Address - Fax:888-778-9471
Practice Address - Street 1:8701 TROOST AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-2767
Practice Address - Country:US
Practice Address - Phone:816-995-2114
Practice Address - Fax:888-778-9471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2010-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9594207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201015328Medicaid
MO201015328Medicaid