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General NPI Number Information
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NPI Number | 1124118955
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Entity Type | Individual
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Provider Name | RAZVAN ADAM MD
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Gender | Male
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | PSC 41 BOX 883
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City | APO
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State | AE
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Zip | 09464-0089
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Country | US
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Telephone | 314-226-8603
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Fax |
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Provider Business Mailing Address
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Address Line | 2699 ANTIETAM CT
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City | ANN ARBOR
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State | MI
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Zip | 48105-1456
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Country | US
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Telephone | 989-423-0672
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 4301062869
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 4301062869
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License Number State | MI
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