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Individual

HATEM M ATAYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
611 COURT ST, WEST BRANCH, MI 48661-9390
(989) 345-1000
(989) 345-3163
Mailing address
611 COURT ST, PO BOX 428, WEST BRANCH, MI 48661-9390
(989) 345-1000
(989) 345-3163

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301079461
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4698473
MI
01
OF51015
BLUE CROSS GROUP
MI
Enumeration date
01/24/2006
Last updated
02/28/2008
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