Basic Information
Provider Information
NPI: 1518491927
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ATKINSON
FirstName: WENDY
MiddleName: LAURA
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1202 MEDICAL CENTER DR
Address2:  
City: WILMINGTON
State: NC
PostalCode: 284017307
CountryCode: US
TelephoneNumber: 9103413300
FaxNumber: 9102512067
Practice Location
Address1: 1202 MEDICAL CENTER DR
Address2:  
City: WILMINGTON
State: NC
PostalCode: 284017307
CountryCode: US
TelephoneNumber: 9103413300
FaxNumber: 9102512067
Other Information
ProviderEnumerationDate: 04/13/2017
LastUpdateDate: 07/08/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/08/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X2020-03243NCY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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