Provider Demographics
NPI:1588823645
Name:ZUCKER, ADAM JACOB (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:JACOB
Last Name:ZUCKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:77 ACCORD PARK DR D4
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1652
Mailing Address - Country:US
Mailing Address - Phone:781-952-1526
Mailing Address - Fax:781-878-8627
Practice Address - Street 1:541 MAIN ST 400
Practice Address - Street 2:
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1889
Practice Address - Country:US
Practice Address - Phone:781-952-1240
Practice Address - Fax:781-826-8043
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO52680207RC0000X
MA240220207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
COIM/CARDIOLOGYOther207R000000X