Healthcare Provider Details

I. General information

NPI: 1659323913
Provider Name (Legal Business Name): STEVEN A. ADELMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 08/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 INDEPENDENCE DR
CHESTNUT HILL MA
02467-3628
US

IV. Provider business mailing address

147 MILK ST PROVIDER ENROLLMENT 9TH FLOOR
BOSTON MA
02109-4806
US

V. Phone/Fax

Practice location:
  • Phone: 617-541-6575
  • Fax: 617-541-7510
Mailing address:
  • Phone: 617-559-8051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number49629
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: