Provider Demographics
NPI:1285634352
Name:ATLAS, IAN (MD)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:
Last Name:ATLAS
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:PO BOX 912
Mailing Address - Street 2:
Mailing Address - City:WHIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07981-0912
Mailing Address - Country:US
Mailing Address - Phone:973-206-8282
Mailing Address - Fax:973-599-1695
Practice Address - Street 1:261 JAMES ST
Practice Address - Street 2:SUITE 3A
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6392
Practice Address - Country:US
Practice Address - Phone:973-206-8282
Practice Address - Fax:973-599-1695
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA58005208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ340008601OtherRAILROAD MC PROVIDER#
NJ0529325OtherAETNA PROVIDER ID
NJJ21209OtherHEALTHNET
NJIS151OtherOXFORD PROVIDER ID
NJ1363735OtherUNITED HEALTHCARE
NJ1394680OtherCIGNA
NJ0529325OtherAETNA PROVIDER ID
NJIS151OtherOXFORD PROVIDER ID