Provider Demographics
NPI:1174663835
Name:MAMELAK, ADAM JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:JOSEPH
Last Name:MAMELAK
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Gender:M
Credentials:MD
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Mailing Address - Street 1:12319 N MOPAC EXPY
Mailing Address - Street 2:BLDG. C, STE. 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2403
Mailing Address - Country:US
Mailing Address - Phone:512-837-3376
Mailing Address - Fax:512-837-3377
Practice Address - Street 1:12319 N MOPAC EXPY
Practice Address - Street 2:BLDG. C, STE. 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-2403
Practice Address - Country:US
Practice Address - Phone:512-837-3376
Practice Address - Fax:512-837-3377
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2020-10-09
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Provider Licenses
StateLicense IDTaxonomies
TXM6272207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery