Provider Demographics
NPI:1043514623
Name:FRONTIER NEUROSURGERY PLLC
Entity Type:Organization
Organization Name:FRONTIER NEUROSURGERY PLLC
Other - Org Name:NOVA HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:S
Authorized Official - Last Name:ATTEBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-759-8895
Mailing Address - Street 1:6101 SUMMITVIEW AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-3028
Mailing Address - Country:US
Mailing Address - Phone:509-902-8857
Mailing Address - Fax:509-902-8855
Practice Address - Street 1:6101 SUMMITVIEW AVE STE 200
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-3028
Practice Address - Country:US
Practice Address - Phone:509-902-8857
Practice Address - Fax:509-902-8855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60125296332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies