Provider Demographics
NPI:1437144839
Name:ZALATIMO, AKRAM A (MD)
Entity Type:Individual
Prefix:DR
First Name:AKRAM
Middle Name:A
Last Name:ZALATIMO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-038606-L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008106820005Medicaid
PAC33597Medicare UPIN
PA0008106820005Medicaid