Basic Information
| Provider Information | |||||||||
| NPI: | 1699764688 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOHAMED | ||||||||
| FirstName: | MAHMOUD | ||||||||
| MiddleName: | ABDELMONEM | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 460 MAIN ST | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | MADAWASKA | ||||||||
| State: | ME | ||||||||
| PostalCode: | 047561014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2077287300 | ||||||||
| FaxNumber: | 2077287838 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 EAST BRIN STREET | ||||||||
| Address2: | TERRELL STATE HOSPITAL | ||||||||
| City: | TERRELL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725518166 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2005 | ||||||||
| LastUpdateDate: | 09/13/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 016849 | ME | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | N5875 | TX | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.