Provider Demographics
NPI:1558559518
Name:KOELSCH, ADAM R (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:R
Last Name:KOELSCH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:9522 E SAN SALVADOR DR
Mailing Address - Street 2:SUITE 317
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5557
Mailing Address - Country:US
Mailing Address - Phone:480-767-1190
Mailing Address - Fax:480-614-1934
Practice Address - Street 1:9522 E SAN SALVADOR DR
Practice Address - Street 2:SUITE 317
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5557
Practice Address - Country:US
Practice Address - Phone:480-767-1190
Practice Address - Fax:480-614-1934
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
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Provider Licenses
StateLicense IDTaxonomies
AZ319452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
79246Medicare PIN
I02967Medicare UPIN