Basic Information
| Provider Information | |||||||||
| NPI: | 1508206673 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ATAR | ||||||||
| FirstName: | OLIVER | ||||||||
| MiddleName: | DAVID | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 TUURI PL APT 112 | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485032441 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5193282138 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 HURLEY PLAZA | ||||||||
| Address2: | HURLEY MEDICAL CENTER | ||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102629000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2013 | ||||||||
| LastUpdateDate: | 07/03/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 4301103804 | MI | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.