Provider Demographics
NPI:1255300653
Name:ADAMS, DIANA M (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:M
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5 PERRYRIDGE RD
Mailing Address - Street 2:SUITE 3-334
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-4608
Mailing Address - Country:US
Mailing Address - Phone:203-863-3674
Mailing Address - Fax:203-863-3467
Practice Address - Street 1:5 PERRYRIDGE RD
Practice Address - Street 2:SUITE 3-334
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-4608
Practice Address - Country:US
Practice Address - Phone:203-863-3674
Practice Address - Fax:203-863-3467
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT052077174400000X
CT52077207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAE69930Medicare UPIN