Healthcare Provider Details

I. General information

NPI: 1255271276
Provider Name (Legal Business Name): EXETER MEDICAL ALLIACE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 MONUMENT RD APT 335
BALA CYNWYD PA
19004-1759
US

IV. Provider business mailing address

130 MONUMENT RD APT 335
BALA CYNWYD PA
19004-1759
US

V. Phone/Fax

Practice location:
  • Phone: 856-325-0351
  • Fax:
Mailing address:
  • Phone: 856-325-0351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. ADAM CHAKOV
Title or Position: OWNER
Credential: MD
Phone: 856-325-0351