1184813503 NPI number — CYRUS HAMIDI, M.D., P.A.

Table of content: (NPI 1184813503)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184813503 NPI number — CYRUS HAMIDI, M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CYRUS HAMIDI, M.D., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1184813503
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
913 RIDGEBROOK RD
Provider Second Line Business Mailing Address:
SUITE 312
Provider Business Mailing Address City Name:
SPARKS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21152-9455
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-472-6560
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
913 RIDGEBROOK RD
Provider Second Line Business Practice Location Address:
SUITE 312
Provider Business Practice Location Address City Name:
SPARKS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21152-9455
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-472-6560
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HAMIDI
Authorized Official First Name:
CYRUS
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING PHYSICIAN
Authorized Official Telephone Number:
410-472-6560

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 377R . This is a "INDIVIDUAL MEDICARE PIN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1134102775 . This is a "INDIVIDUAL NPI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com