Provider Demographics
NPI:1194246777
Name:ELMATITE, WALEED (MD)
Entity type:Individual
Prefix:
First Name:WALEED
Middle Name:
Last Name:ELMATITE
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 1:1022 DELAWARE AVE APT A1
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209-1639
Mailing Address - Country:US
Mailing Address - Phone:716-578-4800
Mailing Address - Fax:
Practice Address - Street 1:1022 DELAWARE AVE APT A1
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-1639
Practice Address - Country:US
Practice Address - Phone:716-578-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPO1847207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology