Provider Demographics
NPI:1578951695
Name:ELTAHIR, AIMAN T (DPT)
Entity Type:Individual
Prefix:
First Name:AIMAN
Middle Name:T
Last Name:ELTAHIR
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9741 HILLSMERE RD
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-3731
Mailing Address - Country:US
Mailing Address - Phone:443-812-4383
Mailing Address - Fax:
Practice Address - Street 1:9741 HILLSMERE RD
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-3731
Practice Address - Country:US
Practice Address - Phone:443-812-4383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-23
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCP019069T225100000X
MTCP019070T225100000X
SCCP019071T225100000X
SDCP019073225100000X
VACP019074T225100000X
MD25355225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD8825 - 0034OtherCAREFIRST