Provider Demographics
NPI:1275863714
Name:SCUDDER, ADAM K (CRNA)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:K
Last Name:SCUDDER
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Gender:M
Credentials:CRNA
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Mailing Address - Street 1:1 TAMPA GENERAL CIR
Mailing Address - Street 2:SUITE A327
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-3571
Mailing Address - Country:US
Mailing Address - Phone:813-844-4396
Mailing Address - Fax:813-844-4972
Practice Address - Street 1:1 TAMPA GENERAL CIR
Practice Address - Street 2:SUITE A327
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3571
Practice Address - Country:US
Practice Address - Phone:813-844-4396
Practice Address - Fax:813-844-4972
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2011-10-21
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Provider Licenses
StateLicense IDTaxonomies
IL209.007970367500000X
WI148864-30367500000X
FLARNP 9329559367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered