Shaban Mahmoud, MD

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

74977 Issued in OH

Practice address

1330 Coshocton Ave
Mount Vernon, OH 43050-1440

Phone

(740) 393-9000

NPI assigned

Sep 6, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• In House Internists, Inc

  • Internal Medicine Physician
  • Lima, OH
  • NPI 1033312111
  NPD (past)
• In-House Internist LLC

  • Internal Medicine Physician
  • Lima, OH
  • NPI 1912096322
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237939200000",
    "number": "1194719286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 COSHOCTON AVE",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430501440",
            "telephone_number": "740-393-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 COSHOCTON AVE",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430501440",
            "telephone_number": "740-393-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOUD",
        "first_name": "SHABAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2009-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OH",
            "license": "74977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2083632",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000207469",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timberlee B Madeker, CPNP
• Jana Mader
• Heather Magers, CDCA
• Jordan Magers
• Wayne T Mahar Jr., D.D.S.
• Kristie N Maibach, CDCA
• Casey Maidel
• Tricia Malone, LCDC III
• Andrea K Mantell, APRN
• Rachel Marshall, PTA

• Critical Care Medicine (Internal Medicine) Physician in Mount Vernon, OH
• Providers in Mount Vernon, OH by specialty
• Critical Care Medicine (Internal Medicine) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.