1053643346 NPI number — AIDA SEHIC

Table of content: AIDA SEHIC (NPI 1053643346)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053643346 NPI number — AIDA SEHIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEHIC
Provider First Name:
AIDA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053643346
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/11/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11011 MCCORMICK RD
Provider Second Line Business Mailing Address:
200
Provider Business Mailing Address City Name:
HUNT VALLEY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21031-8656
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-481-9185
Provider Business Mailing Address Fax Number:
443-281-5051

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3005 SPRINGCREST DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40241-2755
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-481-9185
Provider Business Practice Location Address Fax Number:
443-281-5051
Provider Enumeration Date:
02/11/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 246Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)