Dr. Ernst Fattakhov, MD
Emergency Medicine in Middletown, NY. Individual provider (NPI-1).
NPI number1164046744
StatusActive
Last updated in NPPESJul 11, 2023
Details
- NPI
- 1164046744
- Entity type
- Individual (NPI-1)
- Name
- Dr. Ernst Fattakhov
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 30, 2020
- Certification date
- Jul 11, 2023
- Last updated
- Jul 11, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | U3839 | TX | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
707 E Main StMiddletown, NY 10940-2650
Phone 845-333-6333
Mailing address
200 Corporate BlvdLafayette, LA 70508-3870
Phone 800-893-9698
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