Healthcare Provider Details

I. General information

NPI: 1528034469
Provider Name (Legal Business Name): ORIN KEITH ATLAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 CREEK CROSSING BLVD
HAINESPORT NJ
08036-2766
US

IV. Provider business mailing address

90 MATAWAN RD STE 302
MATAWAN NJ
07747-2653
US

V. Phone/Fax

Practice location:
  • Phone: 609-261-5800
  • Fax: 609-261-5801
Mailing address:
  • Phone: 732-441-7177
  • Fax: 732-441-7165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number25MA07390600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: