Basic Information
Provider Information
NPI: 1700827177
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ATIEH
FirstName: MAHMOUD
MiddleName: KHADIR
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherCredential:  
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Mailing Information
Address1: 205 PAGE ROAD
Address2:  
City: PINEHURST
State: NC
PostalCode: 283748798
CountryCode: US
TelephoneNumber: 9102955511
FaxNumber:  
Practice Location
Address1: 110 FIELDS DR
Address2: SUITE A
City: SANFORD
State: NC
PostalCode: 273305072
CountryCode: US
TelephoneNumber: 9197779005
FaxNumber: 9197081550
Other Information
ProviderEnumerationDate: 06/09/2006
LastUpdateDate: 01/23/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X9600116NCN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RI0011X9600116NCY Allopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology

No ID Information.


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