Provider Demographics
NPI:1861473050
Name:ADAM, ERDAL BEKIR (OD)
Entity Type:Individual
Prefix:DR
First Name:ERDAL
Middle Name:BEKIR
Last Name:ADAM
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 N MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-2344
Mailing Address - Country:US
Mailing Address - Phone:540-213-7720
Mailing Address - Fax:540-213-7729
Practice Address - Street 1:17 N MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2344
Practice Address - Country:US
Practice Address - Phone:540-213-7720
Practice Address - Fax:540-213-7729
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001414152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010116929Medicaid
006307M61Medicare ID - Type Unspecified