Basic Information
| Provider Information | |||||||||
| NPI: | 1487933446 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALTARAWNEH | ||||||||
| FirstName: | AHMAD | ||||||||
| MiddleName: | HASHEM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 FRANKLIN ST APT 207D | ||||||||
| Address2: | |||||||||
| City: | MORRISTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079605440 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126073289 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4458 MEDICAL DR STE 505 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782293748 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106907400 | ||||||||
| FaxNumber: | 2106907405 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2011 | ||||||||
| LastUpdateDate: | 11/30/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD19287 | ME | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0200X | T3238 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 390200000X | 00000000000000000000 | NJ | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RN0300X | T3238 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.