MEDICARE: DIANE E. ADAM M.D.

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	207V00000X	Obstetrics & Gynecology Physician	30914	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	990010245	OTHER	IA	RAILROAD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	58974	OTHER	IA	BC/BS

General Provider Information

NPI Number	:	1134113061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE E. ADAM M.D.

Provider Business Mailing Address
First Line	:	2769 HEARTLAND DR
Second Line	:	SUITE 201
City	:	CORALVILLE
State	:	IA
Zip	:	52241-2732
Country	:	US
Telephone Number	:	319-337-3173
Fax Number	:	319-545-4570

Provider Business Practice Location Address
First Line	:	2769 HEARTLAND DR
Second Line	:	SUITE 201
City	:	CORALVILLE
State	:	IA
Zip	:	52241-2732
Country	:	US
Telephone Number	:	319-337-3173
Fax Number	:	319-545-4570

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

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	03/07/2023

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Directions to “ DIANE E. ADAM M.D.” Practice Location

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