Provider Demographics
NPI:1457451015
Name:MAYERSON, ADAM B (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:B
Last Name:MAYERSON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:200 ORCHARD ST
Mailing Address - Street 2:SUITE #207
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5363
Mailing Address - Country:US
Mailing Address - Phone:203-776-4444
Mailing Address - Fax:203-776-4441
Practice Address - Street 1:200 ORCHARD ST
Practice Address - Street 2:SUITE #207
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5363
Practice Address - Country:US
Practice Address - Phone:203-776-4444
Practice Address - Fax:203-776-4441
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2009-11-12
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Provider Licenses
StateLicense IDTaxonomies
CT037597207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT460000041Medicare PIN
CTH34676Medicare UPIN