1982637575 NPI number — RONALD W. ATWOOD, M.D., P.C.

Table of content: (NPI 1982637575)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982637575 NPI number — RONALD W. ATWOOD, M.D., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RONALD W. ATWOOD, M.D., P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982637575
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/24/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
108 KNELLS RIDGE BLVD
Provider Second Line Business Mailing Address:
SUITE 108
Provider Business Mailing Address City Name:
CHESAPEAKE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23320-4885
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-436-1234
Provider Business Mailing Address Fax Number:
757-548-3665

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
108 KNELLS RIDGE BLVD
Provider Second Line Business Practice Location Address:
SUITE 108
Provider Business Practice Location Address City Name:
CHESAPEAKE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23320-4885
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-436-1234
Provider Business Practice Location Address Fax Number:
757-548-3665
Provider Enumeration Date:
07/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ATWOOD
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
757-436-1234

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 091662 . This is a "BCBS GROUP" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: CH1314 . This is a "RR MCARE GROUP" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com