Basic Information
Provider Information
NPI: 1104808047
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AL-HOMSI
FirstName: AHMAD
MiddleName: SAMER
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9910 FRANKLIN SQUARE DR STE 2110
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212364902
CountryCode: US
TelephoneNumber: 4109336421
FaxNumber: 4109331390
Practice Location
Address1: 600 N WOLFE ST
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212870005
CountryCode: US
TelephoneNumber: 4109555000
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/16/2005
LastUpdateDate: 12/06/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003XD84409MDY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

ID Information
IDTypeStateIssuerDescription
D8440901MDPHYSICIAN LICENSEOTHER


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