Provider Demographics
NPI:1376594630
Name:ADELMAN, PHILIP A (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:A
Last Name:ADELMAN
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 1:21 INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1610
Mailing Address - Country:US
Mailing Address - Phone:610-647-8000
Mailing Address - Fax:610-647-6394
Practice Address - Street 1:21 INDUSTRIAL BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1610
Practice Address - Country:US
Practice Address - Phone:610-647-8000
Practice Address - Fax:610-647-6394
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041240E2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B37345Medicare UPIN
B37345Medicare UPIN