Provider Demographics
NPI:1629006028
Name:ADAMS, ALBERT W (MD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:W
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 1:399 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-2322
Mailing Address - Country:US
Mailing Address - Phone:207-989-9821
Mailing Address - Fax:207-989-9822
Practice Address - Street 1:399 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-2322
Practice Address - Country:US
Practice Address - Phone:207-989-9821
Practice Address - Fax:207-989-9822
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME014557208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME317070000Medicaid
ME098677OtherBLUE SHIELD
ME0193422OtherCIGNA
ME5376617OtherAETNA
ME317070000Medicaid