Provider Demographics
NPI:1134100456
Name:DARCY, ADAM W (DPM)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:W
Last Name:DARCY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 MOUNT HOPE AVE STE 620
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-5671
Mailing Address - Country:US
Mailing Address - Phone:207-947-2220
Mailing Address - Fax:207-947-4073
Practice Address - Street 1:700 MOUNT HOPE AVE STE 620
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-5671
Practice Address - Country:US
Practice Address - Phone:207-947-2220
Practice Address - Fax:207-947-4073
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPOD 1044213E00000X, 213ER0200X, 213ES0000X, 213ES0103X
MEPOD1044213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME270040099Medicaid
MEME0025Medicare ID - Type Unspecified
U96106Medicare UPIN