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General NPI Number Information
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NPI Number | 1144498924
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Entity Type | Organization
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Legal Business Name | ANTOINETTE D ADAMS, DPM, PC
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Dates
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Enumeration Date | 02/14/2008
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 1035 CHAMPIONS WAY SUITE 700 HARBOUR VIEW PROFESSIONAL CENTER, BUILDING 2
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City | SUFFOLK
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State | VA
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Zip | 23435
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Country | US
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Telephone | 757-686-3668
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Fax | 757-686-3669
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Provider Business Mailing Address
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Address Line | PO BOX 5495
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City | SUFFOLK
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State | VA
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Zip | 23435-5494
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Country | US
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Telephone | 757-686-3668
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Fax | 757-686-3669
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANTOINETTE DENISE ADAMS
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Credential | D.P.M.
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Telephone | 757-686-3668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0103300897
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License Number State | VA
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