Provider Demographics
NPI:1982637575
Name:RONALD W. ATWOOD, M.D., P.C.
Entity Type:Organization
Organization Name:RONALD W. ATWOOD, M.D., P.C.
Other - Org Name:ATWOOD FAMILY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:ATWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-436-1234
Mailing Address - Street 1:108 KNELLS RIDGE BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4885
Mailing Address - Country:US
Mailing Address - Phone:757-436-1234
Mailing Address - Fax:757-548-3665
Practice Address - Street 1:108 KNELLS RIDGE BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4885
Practice Address - Country:US
Practice Address - Phone:757-436-1234
Practice Address - Fax:757-548-3665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA091662OtherBCBS GROUP
CH1314OtherRR MCARE GROUP
CH1314OtherRR MCARE GROUP