Provider Demographics
NPI:1891964292
Name:FEINSTEIN, ADAM GREGG (DO)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:GREGG
Last Name:FEINSTEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37040 GARFIELD RD STE C-2
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-3646
Mailing Address - Country:US
Mailing Address - Phone:586-840-7599
Mailing Address - Fax:586-840-7597
Practice Address - Street 1:37040 GARFIELD RD STE C-2
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48036-3646
Practice Address - Country:US
Practice Address - Phone:586-840-7599
Practice Address - Fax:586-840-7597
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017208204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1891964292Medicaid
MI1891964292Medicaid