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ATHAR ALTAF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
675 BALTIMORE DR, WILKES BARRE, PA 18702-7900
(570) 808-5780
(570) 808-5753
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
39759
KY
207RG0100X
Gastroenterology Physician
Primary
MD437577
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102329894
PA
Enumeration date
05/15/2006
Last updated
08/05/2020
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