Healthcare Provider Details

I. General information

NPI: 1669726139
Provider Name (Legal Business Name): JAMES ADLEBERG DPM, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2012
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8100 SANDPIPER CIR STE 104
NOTTINGHAM MD
21236-5028
US

IV. Provider business mailing address

8100 SANDPIPER CIR STE 104
NOTTINGHAM MD
21236-5028
US

V. Phone/Fax

Practice location:
  • Phone: 410-933-3300
  • Fax: 410-933-3303
Mailing address:
  • Phone: 410-933-3300
  • Fax: 410-933-3303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number01012
License Number StateMD

VIII. Authorized Official

Name: DR. JAMES STEPHEN ADLEBERG
Title or Position: CORPORATE OFFICER
Credential: DPM
Phone: 410-933-3300