Provider Demographics
NPI:1508206673
Name:ATAR, OLIVER DAVID (MD)
Entity Type:Individual
Prefix:
First Name:OLIVER
Middle Name:DAVID
Last Name:ATAR
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 1:801 TUURI PL APT 112
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-2441
Mailing Address - Country:US
Mailing Address - Phone:519-328-2138
Mailing Address - Fax:
Practice Address - Street 1:1 HURLEY PLAZA
Practice Address - Street 2:HURLEY MEDICAL CENTER
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503
Practice Address - Country:US
Practice Address - Phone:810-262-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301103804390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program