Provider Demographics
NPI:1235155854
Name:ADELMAN, RICHARD A JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:ADELMAN
Suffix:JR
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 1:738 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-2524
Mailing Address - Country:US
Mailing Address - Phone:850-747-8346
Mailing Address - Fax:850-747-9649
Practice Address - Street 1:738 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-2524
Practice Address - Country:US
Practice Address - Phone:850-747-8346
Practice Address - Fax:850-747-9649
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME43574174400000X, 202K00000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No174400000XOther Service ProvidersSpecialist
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0704755OtherUNITED HEALTHCARE PROVIDE
FL4278623OtherAETNA PIN
FL03614OtherBCBS PROVIDER ID
FL4278623OtherAETNA PIN
FLP00252231Medicare PIN
FLK7013Medicare ID - Type UnspecifiedPROVIDER ID