Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 200000707 | NC |
NPI | 1053397539 |
---|---|
Provider Name | Hal H Atkinson |
First Address | Winston Salem, NC 27102-0344 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2005 |
Last Update Date | 12/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1302A | BCBS (01) | |
49063 | PARTNERS (01) | |
5877016 | (05) | VA |
7436671 | AETNA (01) | |
891302A | (05) | NC |
B5057 | MEDCOST (01) | |
H63217 | (02) |