Individual
DR. ERNST FATTAKHOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
707 E MAIN ST, MIDDLETOWN, NY 10940-2650
(845) 333-6333
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
U3839
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/30/2020
Last updated
07/11/2023
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