Provider Demographics
NPI:1578637294
Name:ADAMS, JOSEPH A (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:ADAMS
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 1:1405 BERWICK RD
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6509
Mailing Address - Country:US
Mailing Address - Phone:410-339-7108
Mailing Address - Fax:410-823-7401
Practice Address - Street 1:6701 N CHARLES ST
Practice Address - Street 2:SUITE 4104
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-6808
Practice Address - Country:US
Practice Address - Phone:410-231-3323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0032783207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1100706OtherAETNA HMO
DCR4760001OtherCAREFIRST OF DC
MD10780000000OtherPREFERRED HEALTH NETWORK
MD1410OtherCAREFIRST OF MD
MD000138227008OtherUNITED HEALTHCARE
MD1393924OtherCIGNA HEALTHCARE
MD5620093OtherAETNA PPO
MD621491600Medicaid
MD1393924OtherCIGNA HEALTHCARE
MDD73788Medicare UPIN
MD110191230Medicare ID - Type UnspecifiedRAILROAD MEDICARE