Provider Demographics
NPI:1336109271
Name:MCBRIDE, ADAM S (DC)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:S
Last Name:MCBRIDE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 466
Mailing Address - Street 2:
Mailing Address - City:CORNISH
Mailing Address - State:ME
Mailing Address - Zip Code:04020-0466
Mailing Address - Country:US
Mailing Address - Phone:207-625-8100
Mailing Address - Fax:207-625-8900
Practice Address - Street 1:202 MAPLE ST
Practice Address - Street 2:SUITE A
Practice Address - City:CORNISH
Practice Address - State:ME
Practice Address - Zip Code:04020-3138
Practice Address - Country:US
Practice Address - Phone:207-625-8100
Practice Address - Fax:207-625-8900
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1306111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME061116OtherANTHEM PROVIDER #
MECOME1007Medicare ID - Type UnspecifiedGROUP NUMBER
MEU92032Medicare UPIN
ME061116OtherANTHEM PROVIDER #