IndividualActive
Percy Botchway, ATC
NPI 1942856521 · Sports Medicine (Emergency Medicine) Physician · Shoreview, MN
Provider details
- NPI number
- 1942856521
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Emergency Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- Yes
- License
- 2681 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
956 Carmel Ct
Shoreview, MN 55126-5882
Phone: (651) 890-9103
Approximate (ZIP-level) locationGet directions
Mailing address
956 Carmel Ct
Shoreview, MN 55126-5882
Registry dates
- Enumerated
- 2019-08-10
- Last updated
- 2019-08-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.