Healthcare Provider Details

I. General information

NPI: 1316188840
Provider Name (Legal Business Name): DOUGLAS GEORGE ADAMS DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2009
Last Update Date: 09/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 MARSH RD STORE 505
WILMINGTON DE
19810-4581
US

IV. Provider business mailing address

33 SHELLBURNE DR
WILMINGTON DE
19803-4945
US

V. Phone/Fax

Practice location:
  • Phone: 302-475-7500
  • Fax:
Mailing address:
  • Phone: 302-521-8323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberJ1-0002424
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: