MEDICARE: DR. ADAM DAVID ZUCKERMAN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH8746	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	89500	OTHER		BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1033226295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM DAVID ZUCKERMAN D.C.

Provider Business Mailing Address
First Line	:	4895 WINDWARD PASSAGE DR
Second Line	:	SUITE 9
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-7741
Country	:	US
Telephone Number	:	561-752-4646
Fax Number	:	561-737-7664

Provider Business Practice Location Address
First Line	:	4895 WINDWARD PASSAGE DR
Second Line	:	SUITE 9
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-7741
Country	:	US
Telephone Number	:	561-752-4646
Fax Number	:	561-737-7664

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	07/08/2007

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