Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301094947 | MI |
N | 2080A0000X | Adolescent Medicine | A64575 | CA |
NPI | 1235217811 |
---|---|
Provider Name | Dr. Thomas L. Atkins |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-5020 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 31/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G90303 | (02) |