Healthcare Provider Details

I. General information

NPI: 1497909097
Provider Name (Legal Business Name): DEBORAH M. ADAMS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2008
Last Update Date: 10/26/2020
Certification Date: 10/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 UNIVERSITY LN STE B
ORANGE VA
22960-2243
US

IV. Provider business mailing address

PO BOX 9007
CHARLOTTESVILLE VA
22906-9007
US

V. Phone/Fax

Practice location:
  • Phone: 540-661-3004
  • Fax: 434-244-4508
Mailing address:
  • Phone: 434-295-1000
  • Fax: 434-972-4266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110005364
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: