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NPI Code Detail

MEDICARE: DR. ELLEN D ADAMS MD

MEDICARE: DR. ELLEN D ADAMS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207LP2900XPain Medicine (Anesthesiology) Physician0101236210VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11067774OTHERWAWORKER'S COMPENSATION
2K142-0001OTHERVACARE FIRST 2005
39385081OTHERVAPHCS
4033579OTHERVATRIGON
5484645OTHERVANCPPO

General Provider Information

NPI Number : 1871594796
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELLEN D ADAMS MD
Provider Business Mailing Address
First Line : PO BOX 7159
Second Line :
City : FAIRFAX STATION
State : VA
Zip : 22039-7159
Country : US
Telephone Number : 703-295-9360
Fax Number : 703-295-9369
Provider Business Practice Location Address
First Line : 3600 JOSEPH SIEWICK DR
Second Line :
City : FAIRFAX
State : VA
Zip : 22033-1709
Country : US
Telephone Number : 703-295-9360
Fax Number : 703-295-9369
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2005
Last Update Date : 07/09/2007

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Directions to “ DR. ELLEN D ADAMS MD” Practice Location

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