Provider Demographics
NPI:1811211592
Name:MARTIN, ADAM A (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:A
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:301 CONCOURSE BLVD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-5643
Mailing Address - Country:US
Mailing Address - Phone:804-549-4040
Mailing Address - Fax:804-549-4032
Practice Address - Street 1:6946 FOREST AVE STE 200
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1701
Practice Address - Country:US
Practice Address - Phone:804-549-4040
Practice Address - Fax:804-549-4032
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2019-05-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101255973207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology