Provider Demographics
NPI:1871729178
Name:ATKIN, RUSSELL (MD)
Entity type:Individual
Prefix:
First Name:RUSSELL
Middle Name:
Last Name:ATKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 CORDAGE PARK CIR
Mailing Address - Street 2:SUITE 317
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-7331
Mailing Address - Country:US
Mailing Address - Phone:508-830-2082
Mailing Address - Fax:508-830-2502
Practice Address - Street 1:95 TREMONT ST
Practice Address - Street 2:SUITE 10
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-4738
Practice Address - Country:US
Practice Address - Phone:781-934-7592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA245106207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology