Provider Demographics
NPI:1821134644
Name:COURCHAINE, ADAM (PA-C)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:COURCHAINE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W COUNTY LINE RD
Mailing Address - Street 2:APT 31-202
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-6512
Mailing Address - Country:US
Mailing Address - Phone:774-219-9311
Mailing Address - Fax:
Practice Address - Street 1:7200 E DRY CREEK RD STE G101
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-2574
Practice Address - Country:US
Practice Address - Phone:720-647-7460
Practice Address - Fax:720-684-5766
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4256363AM0700X
MAAP2155207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine