Healthcare Provider Details

I. General information

NPI: 1942402276
Provider Name (Legal Business Name): DAVID E ATKINSON MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MAIN ST
NORWAY MI
49870-1238
US

IV. Provider business mailing address

500 MAIN ST
NORWAY MI
49870-1238
US

V. Phone/Fax

Practice location:
  • Phone: 906-563-9255
  • Fax: 906-563-9706
Mailing address:
  • Phone: 906-563-9255
  • Fax: 906-563-9706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number22074-020
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2358
License Number StateSD
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301042217
License Number StateMI

VIII. Authorized Official

Name: DR. DAVID E ATKINSON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 906-563-9255