Provider Demographics
NPI:1790879773
Name:VLAHOYIANNIS, THEODOROS (PT)
Entity Type:Individual
Prefix:MR
First Name:THEODOROS
Middle Name:
Last Name:VLAHOYIANNIS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8005 HARFORD RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-5701
Mailing Address - Country:US
Mailing Address - Phone:410-663-3133
Mailing Address - Fax:410-663-3089
Practice Address - Street 1:8005 HARFORD RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-5701
Practice Address - Country:US
Practice Address - Phone:410-663-3133
Practice Address - Fax:410-663-3089
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16085225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKU58OtherBLUE CROSS OF MD
MDW338OtherBLUE CROSS FEDERAL
MD232922OtherMAMSI
MDS06421Medicare UPIN
MD213LMedicare ID - Type Unspecified