Healthcare Provider Details

I. General information

NPI: 1316039928
Provider Name (Legal Business Name): ATWOOD & CLARK CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 01/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3548 ELLWOOD ROAD
NEW CASTLE PA
16101
US

IV. Provider business mailing address

3548 ELLWOOD ROAD
NEW CASTLE PA
16101
US

V. Phone/Fax

Practice location:
  • Phone: 724-658-9477
  • Fax: 724-658-9476
Mailing address:
  • Phone: 724-658-9477
  • Fax: 724-658-9476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ATA ULHAQ
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 724-658-9477