Healthcare Provider Details

I. General information

NPI: 1912544800
Provider Name (Legal Business Name): DIANA CHRISTINE ADAMSON PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2019
Last Update Date: 02/24/2022
Certification Date: 02/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 HOSPITAL RD STE 103
PRINCE FREDERICK MD
20678-4029
US

IV. Provider business mailing address

130 HOSPITAL RD STE 103
PRINCE FREDERICK MD
20678-4029
US

V. Phone/Fax

Practice location:
  • Phone: 410-414-4791
  • Fax:
Mailing address:
  • Phone: 410-414-4791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number28456
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number3541
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: