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NPI Code Detail

MEDICARE: DR. JUSTIN HENRY ATWOOD M.D.

MEDICARE: DR. JUSTIN HENRY ATWOOD M.D.
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
1207RC0200XCritical Care Medicine (Internal Medicine) Physician34650SC
2207RP1001XPulmonary Disease Physician34650SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
134650OTHERSCMEDICAL LICENSE
22014022170OTHERMOMEDICAL LICENSE NUMBER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790079085
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUSTIN HENRY ATWOOD M.D.
Provider Business Mailing Address
First Line : PO BOX 23321
Second Line :
City : NEW YORK
State : NY
Zip : 10087-4321
Country : US
Telephone Number : 843-792-6252
Fax Number :
Provider Business Practice Location Address
First Line : 2750 LAUREL ST STE 202
Second Line :
City : COLUMBIA
State : SC
Zip : 29204-2024
Country : US
Telephone Number : 803-865-4590
Fax Number : 803-227-4195
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2011
Last Update Date : 02/05/2026

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