Basic Information
Provider Information
NPI: 1992714752
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ATWOOD
FirstName: MICHAEL
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 901 SW GARFIELD AVE
Address2:  
City: TOPEKA
State: KS
PostalCode: 666061670
CountryCode: US
TelephoneNumber: 7853549591
FaxNumber: 7853680713
Practice Location
Address1: 901 SW GARFIELD AVE
Address2:  
City: TOPEKA
State: KS
PostalCode: 666061670
CountryCode: US
TelephoneNumber: 7853549591
FaxNumber: 7853680713
Other Information
ProviderEnumerationDate: 08/07/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X04-20671KSY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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