Healthcare Provider Details

I. General information

NPI: 1710184957
Provider Name (Legal Business Name): AIMAN S SHAMMAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 09/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6830 HOSPITAL DR SUITE 204
BALTIMORE MD
21237-4373
US

IV. Provider business mailing address

6830 HOSPITAL DR SUITE 204
BALTIMORE MD
21237-4373
US

V. Phone/Fax

Practice location:
  • Phone: 443-559-5063
  • Fax: 443-559-5078
Mailing address:
  • Phone: 443-559-5063
  • Fax: 443-559-5078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberD0065068
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: