MEDICARE: DOUGLAS R ADAMS 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	207L00000X	Anesthesiology Physician	76156	WI
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207LC0200X	Critical Care Medicine (Anesthesiology) Physician	76156	WI

General Provider Information

NPI Number	:	1891157665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS R ADAMS M.D.

Provider Business Mailing Address
First Line	:	325 MAIN ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15201-1709
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	325 MAIN ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15201-1709
Country	:	US
Telephone Number	:	724-689-4007
Fax Number	:

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

Provider Enumeration Date	:	03/22/2016
Last Update Date	:	05/23/2023

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