MEDICARE: DR. ROBERT A ATWELL DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	36001945	OH

General Provider Information

NPI Number	:	1659369155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT A ATWELL DPM

Provider Business Mailing Address
First Line	:	809 COSHOCTON AVE
Second Line	:	SUITE A
City	:	MOUNT VERNON
State	:	OH
Zip	:	43050-1900
Country	:	US
Telephone Number	:	740-397-4262
Fax Number	:	740-392-8257

Provider Business Practice Location Address
First Line	:	809 COSHOCTON AVE
Second Line	:	SUITE A
City	:	MOUNT VERNON
State	:	OH
Zip	:	43050-1900
Country	:	US
Telephone Number	:	740-397-4262
Fax Number	:	740-392-8257

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	04/23/2015

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