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NPI Code Detail

MEDICARE: SENECA TAYLOR ATWOOD

MEDICARE: SENECA TAYLOR ATWOOD
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
1363A00000XPhysician Assistant5601012671MI

General Provider Information

NPI Number : 1124778667
Entity Type Code : Individual
Provider Name (Legal Business Name) : SENECA TAYLOR ATWOOD
Provider Business Mailing Address
First Line : 1 FORD PL STE 3A
Second Line :
City : DETROIT
State : MI
Zip : 48202-3450
Country : US
Telephone Number : 800-999-5829
Fax Number : 313-876-1305
Provider Business Practice Location Address
First Line : 6777 W MAPLE RD
Second Line :
City : WEST BLOOMFIELD
State : MI
Zip : 48322-3013
Country : US
Telephone Number : 248-325-1000
Fax Number : 313-876-1305
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2022
Last Update Date : 01/26/2026

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Directions to “ SENECA TAYLOR ATWOOD ” Practice Location

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