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General NPI Number Information
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NPI Number | 1831359090
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Entity Type | Individual
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Provider Name | OMAR HAMDALLAH M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/11/2008
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Last Update Date | 05/30/2015
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Provider Practice Location Address
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Address Line | 5233 KING AVE SUITE 208
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City | BALTIMORE
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State | MD
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Zip | 21237-4001
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Country | US
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Telephone | 410-918-1525
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Fax | 410-918-1526
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Provider Business Mailing Address
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Address Line | 10845 PHILADELPHIA RD
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City | WHITE MARSH
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State | MD
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Zip | 21162-1717
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Country | US
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Telephone | 410-335-0008
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Fax | 410-335-3113
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | D0077967
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License Number State | MD
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