Provider Demographics
NPI:1871662049
Name:SOLOMON, ADAM (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USA MEDDAC
Mailing Address - Street 2:11050 MOUNT BELVEDERE BLVD
Mailing Address - City:FORT DRUM
Mailing Address - State:NY
Mailing Address - Zip Code:13602
Mailing Address - Country:US
Mailing Address - Phone:315-772-8639
Mailing Address - Fax:
Practice Address - Street 1:USA MEDDAC
Practice Address - Street 2:11050 MOUNT BELVEDERE BLVD
Practice Address - City:FORT DRUM
Practice Address - State:NY
Practice Address - Zip Code:13602
Practice Address - Country:US
Practice Address - Phone:315-772-8639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2468111N00000X, 111N00000X
FLCH8043111N00000X
FL8043111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2023554Medicaid
FL8043OtherFLORDIA CHIROPRACTIC LICENSE
OH2468OtherOHIO CHIROPRACTIC LICENSE
FL8043OtherFLORDIA CHIROPRACTIC LICENSE
OH0837013Medicare PIN
FLCH8043OtherFLORIDA LICENSE
OHU68334Medicare UPIN