Healthcare Provider Details

I. General information

NPI: 1831177120
Provider Name (Legal Business Name): PETER ADAMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7509 CHARLESTOWN PIKE
CHARLESTOWN IN
47111-9623
US

IV. Provider business mailing address

3220 DIXIE HWY
ERLANGER KY
41018-1884
US

V. Phone/Fax

Practice location:
  • Phone: 812-669-0462
  • Fax:
Mailing address:
  • Phone: 606-393-6695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35075474
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number35075474A
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number34285
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number34285
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number01094559A
License Number StateIN
# 6
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number34285
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: