Provider Demographics
NPI:1063507812
Name:BILLET, ADAM (MD,FACS)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:BILLET
Suffix:
Gender:M
Credentials:MD,FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MEDICAL PKWY
Mailing Address - Street 2:SUITE 316
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4985
Mailing Address - Country:US
Mailing Address - Phone:757-547-0047
Mailing Address - Fax:757-548-3370
Practice Address - Street 1:300 MEDICAL PKWY
Practice Address - Street 2:SUITE 316
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4985
Practice Address - Country:US
Practice Address - Phone:757-547-0047
Practice Address - Fax:757-548-3370
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101038458174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6900160Medicaid
VAB08475Medicare UPIN
VA6900160Medicaid