Healthcare Provider Details

I. General information

NPI: 1134100456
Provider Name (Legal Business Name): ADAM W DARCY DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 04/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 MOUNT HOPE AVE STE 620
BANGOR ME
04401-5671
US

IV. Provider business mailing address

700 MOUNT HOPE AVE STE 620
BANGOR ME
04401-5671
US

V. Phone/Fax

Practice location:
  • Phone: 207-947-2220
  • Fax: 207-947-4073
Mailing address:
  • Phone: 207-947-2220
  • Fax: 207-947-4073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPOD 1044
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License NumberPOD 1044
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberPOD 1044
License Number StateME
# 4
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD 1044
License Number StateME
# 5
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPOD1044
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: