Basic Information
Provider Information
NPI: 1871777615
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADAMS
FirstName: CHRISTOPHER
MiddleName: W
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 526 MAIN ST
Address2: STE 302
City: ACTON
State: MA
PostalCode: 017203301
CountryCode: US
TelephoneNumber: 9783717010
FaxNumber: 9783710522
Practice Location
Address1: 147 MILK ST
Address2: DERMATOLOGY DEPT
City: BOSTON
State: MA
PostalCode: 021094806
CountryCode: US
TelephoneNumber: 6176547240
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/27/2007
LastUpdateDate: 07/10/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207N00000X241567MAY Allopathic & Osteopathic PhysiciansDermatology 

No ID Information.


Home