Healthcare Provider Details

I. General information

NPI: 1427412857
Provider Name (Legal Business Name): EMILY ATWOOD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2016
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15204 OMEGA DRIVE SUITE 100
ROCKVILLE MD
20850
US

IV. Provider business mailing address

15204 OMEGA DRIVE SUITE 100
ROCKVILLE MD
20850
US

V. Phone/Fax

Practice location:
  • Phone: 301-279-6750
  • Fax: 301-208-8953
Mailing address:
  • Phone: 301-279-6750
  • Fax: 301-208-8953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0088939
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: