Provider Demographics
NPI:1154512242
Name:ATASSI, AHMAD M (M D)
Entity Type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:M
Last Name:ATASSI
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 HIGHLAND AVE
Mailing Address - Street 2:E3/311
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53792-3252
Mailing Address - Country:US
Mailing Address - Phone:305-585-7500
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:E3/311
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-3252
Practice Address - Country:US
Practice Address - Phone:305-585-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI51860-202085N0700X, 2085R0202X, 2085R0204X, 2085B0100X, 2085D0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Neuroimaging