Provider Demographics
NPI:1457572349
Name:HUTTAM, MAHER A (MD)
Entity Type:Individual
Prefix:
First Name:MAHER
Middle Name:A
Last Name:HUTTAM
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 1:2946 SLEEPY HOLLOW RD
Mailing Address - Street 2:STE 2D
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2003
Mailing Address - Country:US
Mailing Address - Phone:571-969-4242
Mailing Address - Fax:866-866-7719
Practice Address - Street 1:2946 SLEEPY HOLLOW RD
Practice Address - Street 2:STE 2D
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2003
Practice Address - Country:US
Practice Address - Phone:571-969-4242
Practice Address - Fax:866-866-7719
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101241929208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery