Individual
DR. ATAOLLAH LETAFATI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, FACC, FASE
Contact information
Practice address
100 CAMPUS AVENUE, SUITE #102 MEDICAL OFFICE BUILDING, LEWISTON, ME 04240
(207) 777-4080
(207) 777-8903
Mailing address
100 CAMPUS AVENUE, SUITE #102 MEDICAL OFFICE BUILDING, LEWISTON, ME 04240
(207) 777-4080
(207) 777-8903
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
8964ME
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108370000
—
ME
Enumeration date
07/12/2006
Last updated
07/06/2012
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