Provider Demographics
NPI:1346816477
Name:OVERTON, ATTILAH S (CPT)
Entity Type:Individual
Prefix:
First Name:ATTILAH
Middle Name:S
Last Name:OVERTON
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
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Mailing Address - Street 1:5612 HELMONT DR
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3232
Mailing Address - Country:US
Mailing Address - Phone:202-525-6015
Mailing Address - Fax:301-560-3482
Practice Address - Street 1:1209 DUNBAR OAKS DR
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-6625
Practice Address - Country:US
Practice Address - Phone:202-525-6015
Practice Address - Fax:301-560-3482
Is Sole Proprietor?:No
Enumeration Date:2021-05-30
Last Update Date:2021-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD200372Y12246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy