Provider Demographics
NPI:1376638213
Name:ADACHI, TARO JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:TARO
Middle Name:JOHN
Last Name:ADACHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8110 MAPLE LAWN BLVD STE 235
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2694
Mailing Address - Country:US
Mailing Address - Phone:301-340-8339
Mailing Address - Fax:301-340-9027
Practice Address - Street 1:61 THOMAS JOHNSON DR
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4301
Practice Address - Country:US
Practice Address - Phone:301-663-6171
Practice Address - Fax:301-695-4469
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD41017207VX0000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
107649OtherCOVENTRY
533865OtherALLIANCE
533865OtherMAMSI OPT CHOICE MDIA
0233779006OtherCIGNA
MD589081100Medicaid
DA67TJOtherBCBS
4604839OtherAETNA
533865OtherMAMSI OPT CHOICE MDIA
4604839OtherAETNA