Healthcare Provider Details

I. General information

NPI: 1699799619
Provider Name (Legal Business Name): DAVID RAYMOND ADAMS M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RM 10C103 BLDG 10 10 CENTER DRIVE
BETHESDA MD
20892-0001
US

IV. Provider business mailing address

BUILDING 10 RM 10C103 10 CENTER DRIVE
BETHESDA MD
20892-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-402-6435
  • Fax:
Mailing address:
  • Phone: 301-402-6435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License NumberD0060578
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207SG0202X
TaxonomyClinical Biochemical Genetics Physician
License NumberD0060578
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0060578
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: