Healthcare Provider Details

I. General information

NPI: 1720069669
Provider Name (Legal Business Name): ADRIAN KARL HAMBURGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 01/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 WELLS ST
WESTERLY RI
02891-2922
US

IV. Provider business mailing address

25 WELLS ST
WESTERLY RI
02891-2922
US

V. Phone/Fax

Practice location:
  • Phone: 401-348-3865
  • Fax: 401-348-3641
Mailing address:
  • Phone: 401-348-3865
  • Fax: 401-348-3641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberMD12234
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberM3568
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number222796
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number045009
License Number StateCT
# 5
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberMD12234
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: