Provider Demographics
NPI:1154647899
Name:ROTHERMEL, ADAM R (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:R
Last Name:ROTHERMEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2146 BELCOURT AVE
Mailing Address - Street 2:VMG BUSINESS OFFICE
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-3504
Mailing Address - Country:US
Mailing Address - Phone:614-284-7380
Mailing Address - Fax:
Practice Address - Street 1:209 LIGHT HL
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0001
Practice Address - Country:US
Practice Address - Phone:615-322-4916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.121727208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program