Provider Demographics
NPI:1528411212
Name:ATLAS NEUROLOGY, LLC
Entity Type:Organization
Organization Name:ATLAS NEUROLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIAD
Authorized Official - Middle Name:T
Authorized Official - Last Name:CULCEA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-315-5950
Mailing Address - Street 1:401 15TH AVE S STE 101
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-4372
Mailing Address - Country:US
Mailing Address - Phone:406-315-5950
Mailing Address - Fax:406-952-1077
Practice Address - Street 1:401 15TH AVE S STE 101
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4372
Practice Address - Country:US
Practice Address - Phone:406-315-5950
Practice Address - Fax:406-952-1077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-PHYS-LIC-10572174400000X
MTMED-PHYS-LIC10858174400000X
2084E0001X, 2084N0008X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsyGroup - Single Specialty
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular MedicineGroup - Single Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty