Provider Demographics
NPI:1285202127
Name:ADAPA, NUTAN KUMAR
Entity Type:Individual
Prefix:
First Name:NUTAN
Middle Name:KUMAR
Last Name:ADAPA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28592 ORCHARD LAKE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2903
Mailing Address - Country:US
Mailing Address - Phone:248-602-6386
Mailing Address - Fax:248-786-5391
Practice Address - Street 1:28592 ORCHARD LAKE RD STE 300
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2903
Practice Address - Country:US
Practice Address - Phone:248-602-6386
Practice Address - Fax:248-786-5391
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501014714225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist