Provider Demographics
NPI:1972614105
Name:GHILADI, ABDOLHAMID (MD)
Entity type:Individual
Prefix:DR
First Name:ABDOLHAMID
Middle Name:
Last Name:GHILADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:A. HAMID
Other - Middle Name:
Other - Last Name:GHILADI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:7600 OSLER DR
Mailing Address - Street 2:SUITE 111
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7735
Mailing Address - Country:US
Mailing Address - Phone:410-828-8882
Mailing Address - Fax:
Practice Address - Street 1:7600 OSLER DR
Practice Address - Street 2:SUITE 111
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7735
Practice Address - Country:US
Practice Address - Phone:410-828-8882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD-0012849207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD025741900Medicaid
MD025741900Medicaid
MD3527Medicare ID - Type Unspecified