Provider Demographics
NPI:1730671777
Name:HELLAMS, EUGENE JR (CMT,CPT,CSN)
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:
Last Name:HELLAMS
Suffix:JR
Gender:M
Credentials:CMT,CPT,CSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 GREENBELT RD STE E210
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2255
Mailing Address - Country:US
Mailing Address - Phone:301-651-2371
Mailing Address - Fax:855-958-2983
Practice Address - Street 1:9900 GREENBELT RD STE E210
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2255
Practice Address - Country:US
Practice Address - Phone:301-651-2371
Practice Address - Fax:855-958-2983
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT130225X00000X
DC870888225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC1255700522Medicaid