Provider Demographics
NPI:1639119134
Name:DREWES, ADAM L (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:L
Last Name:DREWES
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 1:171 KEMPSVILLE RD
Mailing Address - Street 2:BLDG. B
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4700
Mailing Address - Country:US
Mailing Address - Phone:757-668-6500
Mailing Address - Fax:757-668-6506
Practice Address - Street 1:171 KEMPSVILLE RD
Practice Address - Street 2:BLDG. B
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4700
Practice Address - Country:US
Practice Address - Phone:757-668-6500
Practice Address - Fax:757-668-6506
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101239502208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010267692Medicaid
VA010415C38Medicare PIN
I53900Medicare UPIN