Provider Demographics
NPI:1508088964
Name:AKSADE, ARTUN (MD)
Entity Type:Individual
Prefix:
First Name:ARTUN
Middle Name:
Last Name:AKSADE
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 1:205 S 22ND ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-3810
Mailing Address - Country:US
Mailing Address - Phone:610-253-6201
Mailing Address - Fax:610-258-4705
Practice Address - Street 1:205 S 22ND ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3810
Practice Address - Country:US
Practice Address - Phone:610-253-6201
Practice Address - Fax:610-258-4705
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6565208600000X
PAMD431044208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1019019170002Medicaid
PR101834959OtherMEDICAID GROUP #
PA50081639OtherCAPITAL BLUE CROSS - GROUP #
PA50081642OtherCAPITAL BLUE CROSS - INDIV. #
PA002078081OtherPA HIGHMARK BLUE SHIELD - GROUP #
PA108365OtherMEDICARE GROUP #
PA001964528OtherPA HIGHMARK BLUE SHIELD - INDIV. #
PA001964528OtherPA HIGHMARK BLUE SHIELD - INDIV. #