Healthcare Provider Details

I. General information

NPI: 1689378747
Provider Name (Legal Business Name): ADAM LEONARD MCATEER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

994 RESERVOIR AVE
CRANSTON RI
02910-5122
US

IV. Provider business mailing address

994 RESERVOIR AVE
CRANSTON RI
02910-5122
US

V. Phone/Fax

Practice location:
  • Phone: 401-946-1155
  • Fax:
Mailing address:
  • Phone: 401-946-1155
  • Fax: 401-942-2303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberDPM00385
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberDPM00385
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: