MEDICARE: NAJDAT ATALLAH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	2001004844	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558347187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAJDAT ATALLAH MD

Provider Business Mailing Address
First Line	:	11312 N BLUE SAGE AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93730-8846
Country	:	US
Telephone Number	:	559-538-0862
Fax Number	:

Provider Business Practice Location Address
First Line	:	11312 N BLUE SAGE AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93730-8846
Country	:	US
Telephone Number	:	559-538-0862
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	07/29/2020

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Directions to “ NAJDAT ATALLAH MD” Practice Location

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