Healthcare Provider Details

I. General information

NPI: 1144894353
Provider Name (Legal Business Name): AHMAD TAHAWI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N CAROLINE ST
BALTIMORE MD
21287-0006
US

IV. Provider business mailing address

601 N CAROLINE ST # 3235A
BALTIMORE MD
21287-0006
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-4100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberH0106961
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number5101028174
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: