Basic Information
Provider Information
NPI: 1275988917
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADAMS
FirstName: DANIEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 462 1ST AVE RM 345A
Address2:  
City: NEW YORK
State: NY
PostalCode: 100169196
CountryCode: US
TelephoneNumber: 2122636559
FaxNumber: 2125623001
Practice Location
Address1: 1968 PEACHTREE RD NW
Address2:  
City: ATLANTA
State: GA
PostalCode: 303091281
CountryCode: US
TelephoneNumber: 4046052800
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/02/2016
LastUpdateDate: 05/31/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/31/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X303995NYN Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


Home