Provider Demographics
NPI:1831142033
Name:ROBERT D ADAS DPM PC
Entity Type:Organization
Organization Name:ROBERT D ADAS DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:ADAS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:248-478-6870
Mailing Address - Street 1:33566 W 8 MILE RD
Mailing Address - Street 2:STE C
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-5271
Mailing Address - Country:US
Mailing Address - Phone:248-478-6870
Mailing Address - Fax:248-851-0173
Practice Address - Street 1:33566 W 8 MILE RD
Practice Address - Street 2:STE C
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-5271
Practice Address - Country:US
Practice Address - Phone:248-478-6870
Practice Address - Fax:248-851-0173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRA000922213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5635014OtherBLUE CROSS BLUE SHIELD
MI1392513Medicaid
MI540F323130OtherBCBSM DME
MI5635014OtherBLUE CROSS BLUE SHIELD
MI1392513Medicaid
MI4647030001Medicare NSC