Provider Demographics
NPI:1003071051
Name:FIELDS, ADELE W (MD)
Entity Type:Individual
Prefix:
First Name:ADELE
Middle Name:W
Last Name:FIELDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ADELE
Other - Middle Name:
Other - Last Name:WOYTAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4061 POWDER MILL RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CALVERTON
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3149
Mailing Address - Country:US
Mailing Address - Phone:202-669-8501
Mailing Address - Fax:240-846-1490
Practice Address - Street 1:25500 POINT LOOKOUT RD
Practice Address - Street 2:DEPT. OF RADIOLOGY
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-2015
Practice Address - Country:US
Practice Address - Phone:301-475-6106
Practice Address - Fax:301-475-6431
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD729792085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD050457200Medicaid
MD050457200Medicaid
MD233660YE60Medicare PIN