Provider Demographics
NPI:1104708494
Name:SHALTAMI, AMIR
Entity type:Individual
Prefix:
First Name:AMIR
Middle Name:
Last Name:SHALTAMI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6122 BALMORAL DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-8529
Mailing Address - Country:US
Mailing Address - Phone:614-381-8166
Mailing Address - Fax:
Practice Address - Street 1:6122 BALMORAL DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-8529
Practice Address - Country:US
Practice Address - Phone:614-381-8166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide