Provider Demographics
NPI:1033226295
Name:ZUCKERMAN, ADAM DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:DAVID
Last Name:ZUCKERMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4895 WINDWARD PASSAGE DR
Mailing Address - Street 2:SUITE 9
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-7741
Mailing Address - Country:US
Mailing Address - Phone:561-752-4646
Mailing Address - Fax:561-737-7664
Practice Address - Street 1:4895 WINDWARD PASSAGE DR
Practice Address - Street 2:SUITE 9
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-7741
Practice Address - Country:US
Practice Address - Phone:561-752-4646
Practice Address - Fax:561-737-7664
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8746111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
89500OtherBLUE CROSS BLUE SHIELD
U99810Medicare UPIN
89500OtherBLUE CROSS BLUE SHIELD