Provider Demographics
NPI:1316188840
Name:ADAMS, DOUGLAS GEORGE (DPT)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:GEORGE
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 SHELLBURNE DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-4945
Mailing Address - Country:US
Mailing Address - Phone:302-521-8323
Mailing Address - Fax:
Practice Address - Street 1:1812 MARSH RD
Practice Address - Street 2:STORE 505
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4581
Practice Address - Country:US
Practice Address - Phone:302-475-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0002424208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation