Provider Demographics
NPI:1902969637
Name:MOHABAT, SEEMA (PT)
Entity Type:Individual
Prefix:
First Name:SEEMA
Middle Name:
Last Name:MOHABAT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11314 BROOK RUN DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-6018
Mailing Address - Country:US
Mailing Address - Phone:301-972-3478
Mailing Address - Fax:301-972-3478
Practice Address - Street 1:11314 BROOK RUN DR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-6018
Practice Address - Country:US
Practice Address - Phone:301-972-3478
Practice Address - Fax:301-972-3478
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16548225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
3084675OtherAETNA
MD686610-01OtherCARE FIRST
MD686610-01OtherCARE FIRST