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General NPI Number Information
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NPI Number | 1457699597
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Entity Type | Individual
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Provider Name | ADAM DEWALD MIRAMON DACM, DIPLAC, LAC
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Gender | Male
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Dates
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Enumeration Date | 01/24/2013
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 1645 CONNECTICUT AVENUE NW, 3RD FLOOR
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City | WASHINGTON
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State | DC
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Zip | 20009-1054
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Country | US
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Telephone | 202-297-7404
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Fax | 202-478-2633
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Provider Business Mailing Address
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Address Line | 1645 CONNECTICUT AVENUE NW, 3RD FLOOR
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City | WASHINGTON
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State | DC
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Zip | 20009-1054
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Country | US
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Telephone | 202-297-7404
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Fax | 202-478-2633
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | U02029
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 0191000902
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | CT-0000003
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License Number State | DE
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Taxonomy #4
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC500161
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License Number State | DC
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