Provider Demographics
NPI:1275847063
Name:MAHMOOD, FADEEL HASSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:FADEEL
Middle Name:HASSAN
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 1:20800 HARVARD RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HIGHLAND HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-7249
Mailing Address - Country:US
Mailing Address - Phone:216-383-0100
Mailing Address - Fax:
Practice Address - Street 1:4480 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-5777
Practice Address - Country:US
Practice Address - Phone:216-765-2840
Practice Address - Fax:216-765-2841
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301096892282N00000X
OH35120979208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No282N00000XHospitalsGeneral Acute Care Hospital