Provider Demographics
NPI:1326153511
Name:ADAMS, RICHARD IRVING (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:IRVING
Last Name:ADAMS
Suffix:
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 1:6105 CREEK VIEW TRL
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-6110
Mailing Address - Country:US
Mailing Address - Phone:952-934-8354
Mailing Address - Fax:
Practice Address - Street 1:17705 HUTCHINS DR
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-4145
Practice Address - Country:US
Practice Address - Phone:952-401-8383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN16647207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN174L1ADOtherBLUE CROSS BLUE SHIELD MN
MNHP12764OtherHEALTH PARTNERS
MNA93919Medicare UPIN