Healthcare Provider Details

I. General information

NPI: 1710544499
Provider Name (Legal Business Name): ADAM HOTCHKISS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2019
Last Update Date: 08/16/2021
Certification Date: 07/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 E BIG BEAVER #303
TROY MI
48083
US

IV. Provider business mailing address

PO BOX 596
TROY MI
48099-0596
US

V. Phone/Fax

Practice location:
  • Phone: 707-245-3588
  • Fax:
Mailing address:
  • Phone: 707-245-3588
  • 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 Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number5901400430
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: