Provider Demographics
NPI:1093814311
Name:HAMOD, KAMAL ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMAL
Middle Name:ALEXANDER
Last Name:HAMOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 MACE AVE
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MD
Mailing Address - Zip Code:21221-3315
Mailing Address - Country:US
Mailing Address - Phone:410-847-3500
Mailing Address - Fax:410-847-3504
Practice Address - Street 1:1124 MACE AVE
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221-3315
Practice Address - Country:US
Practice Address - Phone:410-847-3500
Practice Address - Fax:410-847-3504
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0022188207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD01324Medicare UPIN
MD443QMedicare ID - Type Unspecified