Healthcare Provider Details

I. General information

NPI: 1861469942
Provider Name (Legal Business Name): ADAM M FALIK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 02/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7605 FOREST AVE SUITE 102
RICHMOND VA
23229-4938
US

IV. Provider business mailing address

PO BOX 11768
RICHMOND VA
23230-0168
US

V. Phone/Fax

Practice location:
  • Phone: 804-288-3069
  • Fax: 804-288-5464
Mailing address:
  • Phone: 804-545-6875
  • Fax: 804-213-9773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number0101225944
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: