Provider Demographics
NPI:1487636148
Name:ADAMS, DIANE ADEL (DO)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:ADEL
Last Name:ADAMS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:ADEL
Other - Last Name:SCHUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:P O XOX 824804
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-4804
Mailing Address - Country:US
Mailing Address - Phone:302-691-3800
Mailing Address - Fax:302-778-2250
Practice Address - Street 1:620 STANTON CHRISTIANA RD STE 304
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2135
Practice Address - Country:US
Practice Address - Phone:302-691-3800
Practice Address - Fax:302-778-2250
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008635L207V00000X
DEC2-0012979207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology