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General NPI Number Information
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NPI Number | 1982831657
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Entity Type | Individual
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Provider Name | ADAM JOSEPH FITZGERALD M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/19/2009
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 1315 AUBERT AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63113-1918
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Country | US
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Telephone | 314-449-9726
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Fax | 314-449-9641
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Provider Business Mailing Address
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Address Line | 102 WOODMONT BLVD STE 600
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City | NASHVILLE
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State | TN
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Zip | 37205-5250
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Country | US
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Telephone | 615-315-5257
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Fax | 615-692-0547
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 36591
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2012008171
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License Number State | MO
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