Provider Demographics
NPI:1891220836
Name:BARON, ADAM WENDELL (DPM)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:WENDELL
Last Name:BARON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:668 PARK PL
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-2033
Mailing Address - Country:US
Mailing Address - Phone:607-734-4582
Mailing Address - Fax:607-734-4596
Practice Address - Street 1:668 PARK PL
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2033
Practice Address - Country:US
Practice Address - Phone:607-734-4582
Practice Address - Fax:607-734-4596
Is Sole Proprietor?:No
Enumeration Date:2017-04-27
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAEL6779213E00000X
CT1027213E00000X
NYN007108-01213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist