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General NPI Number Information
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NPI Number | 1487933446
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Entity Type | Individual
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Provider Name | AHMAD HASHEM ALTARAWNEH
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Gender | Male
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Dates
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Enumeration Date | 08/09/2011
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Last Update Date | 11/30/2021
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Provider Practice Location Address
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Address Line | 4458 MEDICAL DR STE 505
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3748
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Country | US
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Telephone | 210-690-7400
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Fax | 210-690-7405
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Provider Business Mailing Address
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Address Line | 100 FRANKLIN ST APT 207D
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City | MORRISTOWN
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State | NJ
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Zip | 07960-5440
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Country | US
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Telephone | 612-607-3289
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD19287
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | T3238
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 00000000000000000000
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | T3238
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License Number State | TX
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