Basic Information
| Provider Information | |||||||||
| NPI: | 1871729178 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ATKIN | ||||||||
| FirstName: | RUSSELL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 36 CORDAGE PARK CIR | ||||||||
| Address2: | SUITE 317 | ||||||||
| City: | PLYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023607331 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088302082 | ||||||||
| FaxNumber: | 5088302502 | ||||||||
| Practice Location | |||||||||
| Address1: | 95 TREMONT ST | ||||||||
| Address2: | SUITE 10 | ||||||||
| City: | DUXBURY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023324738 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7819347592 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2009 | ||||||||
| LastUpdateDate: | 07/17/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 245106 | MA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.