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NPI Code Detail

MEDICARE: DR. MICHELLE L TODD MD

MEDICARE: DR. MICHELLE L TODD MD
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
1207Q00000XFamily Medicine Physician54521GA

General Provider Information

NPI Number : 1912992942
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHELLE L TODD MD
Provider Business Mailing Address
First Line : 1247 DONALD LEE HOLLOWELL PKWY NW
Second Line : ASA G. YANCEY, SR., M.D. HEALTH CENTER
City : ATLANTA
State : GA
Zip : 30318-6657
Country : US
Telephone Number : 404-616-2265
Fax Number : 404-616-2825
Provider Business Practice Location Address
First Line : 1247 DONALD LEE HOLLOWELL PKWY NW
Second Line : ASA G. YANCEY, SR., M.D. HEALTH CENTER
City : ATLANTA
State : GA
Zip : 30318-6657
Country : US
Telephone Number : 404-616-2265
Fax Number : 404-616-2825
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2005
Last Update Date : 10/24/2008

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