Provider Demographics
NPI:1164611331
Name:ATALAH, HANY N (MD)
Entity Type:Individual
Prefix:DR
First Name:HANY
Middle Name:N
Last Name:ATALAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 OXFORD RD
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-3039
Mailing Address - Country:US
Mailing Address - Phone:443-799-8823
Mailing Address - Fax:
Practice Address - Street 1:4801 OXFORD RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-3039
Practice Address - Country:US
Practice Address - Phone:443-799-8823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2406208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery