Provider Demographics
NPI:1063449890
Name:ADAMS, AMY GIVENS (MPT)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:GIVENS
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11801 INDUSTRIAL PARK ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-5139
Mailing Address - Country:US
Mailing Address - Phone:301-729-3485
Mailing Address - Fax:301-729-0158
Practice Address - Street 1:11801 INDUSTRIAL PARK ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-5139
Practice Address - Country:US
Practice Address - Phone:301-729-3485
Practice Address - Fax:301-729-0158
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18884225100000X
WV001695225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0158004000Medicaid
MD54631603OtherBLUE CROSS BLUE SHIELD
650016654OtherRAILROAD MEDICARE
MD54631603OtherBLUE CROSS BLUE SHIELD