Provider Demographics
NPI:1497083901
Name:ATALLA, NADER GERGIS (MD)
Entity Type:Individual
Prefix:DR
First Name:NADER
Middle Name:GERGIS
Last Name:ATALLA
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:HEALTH SCIENCES CENTER
Mailing Address - Street 2:300 PRINCE PHILIPS DRIVE
Mailing Address - City:ST. JOHN'S
Mailing Address - State:NEWFOUNDLAND
Mailing Address - Zip Code:A1B 3V6
Mailing Address - Country:CA
Mailing Address - Phone:709-777-8512
Mailing Address - Fax:709-777-6656
Practice Address - Street 1:HEALTH SCIENCES CENTER
Practice Address - Street 2:300 PRINCE PHILIPS DRIVE
Practice Address - City:ST. JOHN'S
Practice Address - State:NEWFOUNDLAND
Practice Address - Zip Code:A1B 3V6
Practice Address - Country:CA
Practice Address - Phone:709-777-8512
Practice Address - Fax:709-777-6656
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012466242084N0400X, 2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology