Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 2017018869 | MO |
NPI | 1023548997 |
---|---|
Provider Name | Danielle Nichole Atwood |
First Address | Columbia, MO 65212-0001 |
Second Address | Columbia, MO 65212-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2017 |
Last Update Date | 16/06/2018 |