Provider Demographics
NPI:1467647487
Name:RICHARD B ATKINS MD PC
Entity Type:Organization
Organization Name:RICHARD B ATKINS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:ATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-960-5106
Mailing Address - Street 1:2300 HAGGERTY RD
Mailing Address - Street 2:SUITE 2160
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-2192
Mailing Address - Country:US
Mailing Address - Phone:248-960-5106
Mailing Address - Fax:248-960-5532
Practice Address - Street 1:2300 HAGGERTY RD
Practice Address - Street 2:SUITE 2160
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48323-2192
Practice Address - Country:US
Practice Address - Phone:248-960-5106
Practice Address - Fax:248-960-5532
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RICHARD B ATKINS MD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRA0576092084F0202X, 2084P0800X, 2084P0804X, 2084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic PsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2606350012OtherBCBSM
MIOP23720Medicare PIN
MIF40890Medicare UPIN