Provider Demographics
NPI:1164616355
Name:AKRAM ZALATIMO,MD
Entity Type:Organization
Organization Name:AKRAM ZALATIMO,MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AKRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZALATIMO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-270-7600
Mailing Address - Street 1:545 N RIVER ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-2600
Mailing Address - Country:US
Mailing Address - Phone:570-270-7600
Mailing Address - Fax:570-270-7602
Practice Address - Street 1:545 N RIVER ST
Practice Address - Street 2:SUITE 110
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-2600
Practice Address - Country:US
Practice Address - Phone:570-270-7600
Practice Address - Fax:570-270-7602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038606L207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008106820005Medicaid
PA0008106820005Medicaid