Provider Demographics
NPI:1457933707
Name:MAHMUD, MUFTAH (MD)
Entity type:Individual
Prefix:DR
First Name:MUFTAH
Middle Name:
Last Name:MAHMUD
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:BANNER UNIVERSITY MEDICAL CENTER
Mailing Address - Street 2:1625 N CAMPBELL AVE
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-4330
Mailing Address - Country:US
Mailing Address - Phone:520-694-0111
Mailing Address - Fax:
Practice Address - Street 1:BANNER UNIVERSITY MEDICAL CENTER
Practice Address - Street 2:1625 N CAMPBELL AVE
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-4330
Practice Address - Country:US
Practice Address - Phone:520-694-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA344041207R00000X
390200000X
AZ75268207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program