Provider Demographics
NPI:1356480362
Name:ATWELL, ANTHONY E (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:E
Last Name:ATWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:51 E. CAMPBELL AVE.
Mailing Address - Street 2:SUITE 170
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008
Mailing Address - Country:US
Mailing Address - Phone:408-291-8585
Mailing Address - Fax:408-370-6196
Practice Address - Street 1:51 E. CAMPBELL AVE.
Practice Address - Street 2:SUITE 170
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008
Practice Address - Country:US
Practice Address - Phone:408-291-8585
Practice Address - Fax:408-370-6196
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2015-04-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC325112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A88968Medicare UPIN