Provider Demographics
NPI:1134102775
Name:HAMIDI, CYRUS (MD)
Entity type:Individual
Prefix:DR
First Name:CYRUS
Middle Name:
Last Name:HAMIDI
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 1:12221 TULLAMORE RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-7816
Mailing Address - Country:US
Mailing Address - Phone:410-308-7840
Mailing Address - Fax:410-308-7841
Practice Address - Street 1:12221 TULLAMORE RD
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-7816
Practice Address - Country:US
Practice Address - Phone:410-308-7840
Practice Address - Fax:410-308-7841
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDCN4738207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD645700200Medicaid
MDG46064Medicare UPIN
MD645700200Medicaid