Provider Demographics
NPI:1689830044
Name:HAMDALLAH, ISAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ISAM
Middle Name:
Last Name:HAMDALLAH
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 1:700 GEIPE ROAD
Mailing Address - Street 2:SUITE 274
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228
Mailing Address - Country:US
Mailing Address - Phone:667-234-8725
Mailing Address - Fax:667-234-8726
Practice Address - Street 1:700 GEIPE ROAD
Practice Address - Street 2:SUITE 274
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228
Practice Address - Country:US
Practice Address - Phone:667-234-8725
Practice Address - Fax:667-234-8726
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD72265208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery