Provider Demographics
NPI:1740582261
Name:ADAMS, ROBERT (OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:ADAMS
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2314 BARKLEY PL
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-1156
Mailing Address - Country:US
Mailing Address - Phone:240-478-8897
Mailing Address - Fax:
Practice Address - Street 1:2314 BARKLEY PL
Practice Address - Street 2:
Practice Address - City:DISTRICT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20747-1156
Practice Address - Country:US
Practice Address - Phone:240-478-8897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-04
Last Update Date:2010-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician