Provider Demographics
NPI:1336756444
Name:MAHMOUD, SALI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SALI
Middle Name:
Last Name:MAHMOUD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6332 WIND RIDER WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-7414
Mailing Address - Country:US
Mailing Address - Phone:410-300-1539
Mailing Address - Fax:
Practice Address - Street 1:7077 ARUNDEL MILLS CIR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-1387
Practice Address - Country:US
Practice Address - Phone:410-379-3102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD201861835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD20186OtherLICENSE