MEDICARE: AGATHA KARIN ATKO DO

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	207Q00000X	Family Medicine Physician	5101012223	MI

General Provider Information

NPI Number	:	1477767218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AGATHA KARIN ATKO DO

Provider Business Mailing Address
First Line	:	9125 ISLAND LAKE RD
Second Line	:
City	:	DEXTER
State	:	MI
Zip	:	48130
Country	:	US
Telephone Number	:	734-426-3582
Fax Number	:

Provider Business Practice Location Address
First Line	:	3606 W LIBERTY RD
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-9049
Country	:	US
Telephone Number	:	734-929-9450
Fax Number	:	734-929-9451

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

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	07/08/2007

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