Provider Demographics
NPI:1114635646
Name:OMRAN, SAJIDAH MAHMOUD (PT, DPT)
Entity type:Individual
Prefix:
First Name:SAJIDAH
Middle Name:MAHMOUD
Last Name:OMRAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8885 CENTRE PARK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2199
Mailing Address - Country:US
Mailing Address - Phone:410-730-1275
Mailing Address - Fax:410-740-2497
Practice Address - Street 1:8885 CENTRE PARK DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2199
Practice Address - Country:US
Practice Address - Phone:410-730-1275
Practice Address - Fax:410-740-2497
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY08669225100000X
MD29777225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist