Healthcare Provider Details

I. General information

NPI: 1023031929
Provider Name (Legal Business Name): GEORGE F ATWEH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 CAMINO DE SALUD NE
ALBUQUERQUE NM
87102-4517
US

IV. Provider business mailing address

933 BRADBURY DR SE STE 2222
ALBUQUERQUE NM
87106-4375
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-4946
  • Fax: 505-272-8060
Mailing address:
  • Phone: 505-272-1320
  • Fax: 505-272-8060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberMD2017-0670
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number042.0012955
License Number StateVT
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number181236
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number35 093949
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: