Provider Demographics
NPI:1881638781
Name:ADAMO, LOUIS C (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:C
Last Name:ADAMO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1789 N KEYSER AVE
Mailing Address - Street 2:MEDICAL ASSOCIATES OF NEPA
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18508
Mailing Address - Country:US
Mailing Address - Phone:570-969-1904
Mailing Address - Fax:570-969-1904
Practice Address - Street 1:1789 N KEYSER AVE
Practice Address - Street 2:MEDICAL ASSOCIATES OF NEPA
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508
Practice Address - Country:US
Practice Address - Phone:570-969-1904
Practice Address - Fax:570-969-2916
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD051356L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014421050004Medicaid
PA407210N25Medicare ID - Type Unspecified
PA0014421050004Medicaid