Healthcare Provider Details

I. General information

NPI: 1245542463
Provider Name (Legal Business Name): ADAM ESKOW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2010
Last Update Date: 06/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5626 SHIELDS DR
BETHESDA MD
20817-3532
US

IV. Provider business mailing address

5626 SHIELDS DR
BETHESDA MD
20817-3532
US

V. Phone/Fax

Practice location:
  • Phone: 301-493-6200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN1001102
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: