Individual
DR. HESHAM MAHMOUD ATWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
620 BELLE TERRE RD, SUITE 5, PORT JEFFERSON, NY 11777-2500
(631) 476-9296
(631) 476-9298
Mailing address
620 BELLE TERRE RD, SUITE 5, PORT JEFFERSON, NY 11777-2500
(631) 476-9296
(631) 476-9298
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
221306
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02229490
—
NY
Enumeration date
09/26/2005
Last updated
10/05/2010
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