Provider Demographics
NPI:1538658646
Name:ATEH, EUGENE
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:
Last Name:ATEH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6404 IVY LN STE 805
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-1420
Mailing Address - Country:US
Mailing Address - Phone:443-571-9994
Mailing Address - Fax:
Practice Address - Street 1:6404 IVY LN STE 805
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-1420
Practice Address - Country:US
Practice Address - Phone:443-571-9994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty