Provider Demographics
NPI:1619994290
Name:ADELSTEIN, DAVID S (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
Last Name:ADELSTEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 SAWYER ST
Mailing Address - Street 2:
Mailing Address - City:WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02571-2003
Mailing Address - Country:US
Mailing Address - Phone:508-295-5289
Mailing Address - Fax:508-291-0579
Practice Address - Street 1:13 SAWYER ST
Practice Address - Street 2:
Practice Address - City:WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02571-2003
Practice Address - Country:US
Practice Address - Phone:508-295-5197
Practice Address - Fax:508-291-0579
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA80727207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA130341OtherHARVARD PILGRIM
MAJ 16182OtherBLUE CROSS BLUE SHIELD
MA000000021824OtherBOSTON HEALTH NET
MA3144186Medicaid
MA0700807OtherUNITED HEALTH CARE
MA080727OtherTUFTS
MA130341OtherHARVARD PILGRIM
MAG06394Medicare UPIN