Provider Demographics
NPI:1447377189
Name:EFTIMIADES, JOHN STEVE (PT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:STEVE
Last Name:EFTIMIADES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14600 KING LEAR CT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-2657
Mailing Address - Country:US
Mailing Address - Phone:301-598-7010
Mailing Address - Fax:301-598-1690
Practice Address - Street 1:5480 WISCONSIN AVE
Practice Address - Street 2:SUITE B1
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-3530
Practice Address - Country:US
Practice Address - Phone:301-598-7010
Practice Address - Fax:301-598-1690
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16614225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD490919Medicare ID - Type UnspecifiedPHYSICAL THERAPY