MEDICARE: DR. DAVID C. ADAMS ED.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	103TC1900X	Counseling Psychologist	6518	MA

General Provider Information

NPI Number	:	1760607717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID C. ADAMS ED.D.

Provider Business Mailing Address
First Line	:	89 LOWELL AVE
Second Line	:	#B
City	:	NEWTONVILLE
State	:	MA
Zip	:	02460-1502
Country	:	US
Telephone Number	:	617-964-3525
Fax Number	:	617-547-9879

Provider Business Practice Location Address
First Line	:	2464 MASSACHUSETTS AVE
Second Line	:	SUITE 101
City	:	CAMBRIDGE
State	:	MA
Zip	:	02140-1646
Country	:	US
Telephone Number	:	617-964-3525
Fax Number	:	617-547-0904

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

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	07/08/2007

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