Healthcare Provider Details

I. General information

NPI: 1356637482
Provider Name (Legal Business Name): HUGH W ADAMS III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2011
Last Update Date: 06/30/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE
ROCHESTER NY
14642
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX MED
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-4517
  • Fax: 585-442-9201
Mailing address:
  • Phone: 585-275-4517
  • Fax: 585-442-9201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0000X
TaxonomyAdolescent Medicine (Internal Medicine) Physician
License Number036135259
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number292685
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: