Healthcare Provider Details

I. General information

NPI: 1164943825
Provider Name (Legal Business Name): MUHTADI HAMED HAMDAN ALNABABTEH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 S EUTAW ST
BALTIMORE MD
21201-1606
US

IV. Provider business mailing address

3883 CONNECTICUT AVE NW APT 902
WASHINGTON DC
20008-4578
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-2864
  • Fax: 443-462-3045
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberD0101563
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberD0101563
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: