Provider Demographics
NPI:1538138508
Name:ATKINS, DAVID N (PAC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:N
Last Name:ATKINS
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2700 S ROCHESTER RD
Mailing Address - Street 2:STE B
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-4547
Mailing Address - Country:US
Mailing Address - Phone:947-252-2002
Mailing Address - Fax:248-575-4144
Practice Address - Street 1:401 S BALLENGER HWY
Practice Address - Street 2:ATTN SURGICAL SERVICES
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3638
Practice Address - Country:US
Practice Address - Phone:810-342-4917
Practice Address - Fax:810-342-1335
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2020-06-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5601002616363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP00199378OtherTRAVELERS
MI0N94260002Medicare ID - Type UnspecifiedWPS