Provider Demographics
NPI:1609946557
Name:KATTAN, BILAL A (MD)
Entity Type:Individual
Prefix:DR
First Name:BILAL
Middle Name:A
Last Name:KATTAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MOHAMMAD-BILAL
Other - Middle Name:AHMED
Other - Last Name:KATTAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:13000 BRUCE B DOWNS BLVD
Mailing Address - Street 2:AMBULATORY CARE SERVICES, VETERAN'S HOSPITAL
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-4745
Mailing Address - Country:US
Mailing Address - Phone:813-500-5766
Mailing Address - Fax:813-500-5766
Practice Address - Street 1:13000 BRUCE B DOWNS BLVD
Practice Address - Street 2:AMBULATORY CARE SERVICES, VETERAN'S HOSPITAL
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-4745
Practice Address - Country:US
Practice Address - Phone:813-500-5766
Practice Address - Fax:813-500-5766
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY149554207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHE47209Medicare UPIN