Healthcare Provider Details

I. General information

NPI: 1205893161
Provider Name (Legal Business Name): JAMIE L ADAM MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 12/02/2025
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 E STATE ST SHARON REGIONAL HEALTH SYSTEM LAB
SHARON PA
16146-3328
US

IV. Provider business mailing address

700 HIGH ST
WILLIAMSPORT PA
17701-3100
US

V. Phone/Fax

Practice location:
  • Phone: 724-983-3952
  • Fax: 724-983-3941
Mailing address:
  • Phone: 570-321-3780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberMD425815
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License NumberMD425815
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: