Healthcare Provider Details

I. General information

NPI: 1356756175
Provider Name (Legal Business Name): ERIK ADAIR D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2014
Last Update Date: 06/17/2020
Certification Date: 06/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 PLEASANT ST
DES MOINES IA
50309-1453
US

IV. Provider business mailing address

1200 PLEASANT ST
DES MOINES IA
50309-1453
US

V. Phone/Fax

Practice location:
  • Phone: 515-241-5437
  • Fax:
Mailing address:
  • Phone: 515-241-5437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number3194
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberUO4290
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberDO-05504
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: