Provider Demographics
NPI:1275657785
Name:ISSA, TAMER S (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:TAMER
Middle Name:S
Last Name:ISSA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15140 DEER VALLEY TER
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-6223
Mailing Address - Country:US
Mailing Address - Phone:301-685-3538
Mailing Address - Fax:
Practice Address - Street 1:4701 RANDOLPH RD
Practice Address - Street 2:SUITE G-1
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2257
Practice Address - Country:US
Practice Address - Phone:301-231-0095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19454225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00350397Medicare ID - Type UnspecifiedRAILROAD MEDICARE PART B
MDG02022I01Medicare ID - Type UnspecifiedMEDICARE PART B-DC METRO