Provider Demographics
NPI:1720797822
Name:ATEM, DESMOND A (DNP)
Entity Type:Individual
Prefix:DR
First Name:DESMOND
Middle Name:A
Last Name:ATEM
Suffix:
Gender:M
Credentials:DNP
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Mailing Address - Street 1:2859 NORTHPARK AVENUE
Mailing Address - Street 2:BERKSHIRE BUILDING, SUITE 110
Mailing Address - City:HUNTINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:46750-7959
Mailing Address - Country:US
Mailing Address - Phone:260-888-9751
Mailing Address - Fax:260-824-7320
Practice Address - Street 1:2859 NORTHPARK AVENUE
Practice Address - Street 2:BERKSHIRE BUILDING, SUITE 110
Practice Address - City:HUNTINGTON
Practice Address - State:IN
Practice Address - Zip Code:46750-7959
Practice Address - Country:US
Practice Address - Phone:260-888-9751
Practice Address - Fax:260-824-7320
Is Sole Proprietor?:No
Enumeration Date:2022-11-16
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COC-RXN.0002570-C-NP363LF0000X
VT101.0135762PROV363LF0000X
WAAP61376005363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily