Provider Demographics
NPI:1134296353
Name:MADDOX, ADAM DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:DAVID
Last Name:MADDOX
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 1:11550 CROSSROADS CIR
Mailing Address - Street 2:UNIT 400
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2973
Mailing Address - Country:US
Mailing Address - Phone:314-605-2485
Mailing Address - Fax:410-216-9669
Practice Address - Street 1:1833 FOREST DR # A
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4429
Practice Address - Country:US
Practice Address - Phone:410-216-9180
Practice Address - Fax:410-216-9669
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor