MEDICARE: MICHAEL M. ATKINSON RPA-C

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	363AM0700X	Medical Physician Assistant	010113	NY

General Provider Information

NPI Number	:	1194726372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL M. ATKINSON RPA-C

Provider Business Mailing Address
First Line	:	105 CANAL LANDING BLVD
Second Line	:	SUITE 1
City	:	ROCHESTER
State	:	NY
Zip	:	14626-5107
Country	:	US
Telephone Number	:	585-368-4050
Fax Number	:	585-723-6705

Provider Business Practice Location Address
First Line	:	105 CANAL LANDING BLVD
Second Line	:	SUITE 1
City	:	ROCHESTER
State	:	NY
Zip	:	14626-5107
Country	:	US
Telephone Number	:	585-368-4050
Fax Number	:	585-723-6705

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	04/19/2021

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