MEDICARE: DR. CYRUS HAMIDI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QG0300X	Geriatric Medicine (Family Medicine) Physician	CN4738	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134102775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYRUS HAMIDI M.D.

Provider Business Mailing Address
First Line	:	12221 TULLAMORE RD
Second Line	:
City	:	LUTHERVILLE TIMONIUM
State	:	MD
Zip	:	21093-7816
Country	:	US
Telephone Number	:	410-308-7840
Fax Number	:	410-308-7841

Provider Business Practice Location Address
First Line	:	12221 TULLAMORE RD
Second Line	:
City	:	LUTHERVILLE TIMONIUM
State	:	MD
Zip	:	21093-7816
Country	:	US
Telephone Number	:	410-308-7840
Fax Number	:	410-308-7841

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2005
Last Update Date	:	11/26/2024

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