Provider Demographics
NPI:1336128693
Name:HULYALKAR, ATUL R (MD)
Entity Type:Individual
Prefix:
First Name:ATUL
Middle Name:R
Last Name:HULYALKAR
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 1:24701 EUCLID AVE
Mailing Address - Street 2:THIRD FLOOR BILLING SERVICES
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:440-250-1806
Mailing Address - Fax:440-835-4788
Practice Address - Street 1:29101 HEALTH CAMPUS DR BLDG 2
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5270
Practice Address - Country:US
Practice Address - Phone:440-250-1806
Practice Address - Fax:440-835-4788
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35065845207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0951671Medicaid
OH0951671Medicaid
OHE84466Medicare UPIN