Provider Demographics
NPI:1750386637
Name:ATKINS, WALTER BEROSKY (DPM)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:BEROSKY
Last Name:ATKINS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2001 MARTIN LUTHER KING JR DR SW
Mailing Address - Street 2:STE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-5801
Mailing Address - Country:US
Mailing Address - Phone:404-755-0020
Mailing Address - Fax:404-755-6960
Practice Address - Street 1:2001 MARTIN LUTHER KING JR DR SW
Practice Address - Street 2:STE 300
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-5801
Practice Address - Country:US
Practice Address - Phone:404-755-0020
Practice Address - Fax:404-755-6960
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000699213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00579862AMedicaid
GA00579862AMedicaid
GAU45128Medicare UPIN