Provider Demographics
NPI:1942355490
Name:CARPENTER, ADAM FORBES (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:FORBES
Last Name:CARPENTER
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 1:717 DELAWARE ST SE
Mailing Address - Street 2:CTSI ROOM 217
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414
Mailing Address - Country:US
Mailing Address - Phone:612-626-5890
Mailing Address - Fax:612-626-2131
Practice Address - Street 1:420 DELAWARE ST SE, CLINIC 1A
Practice Address - Street 2:PHILLIPS WANGENSTEEN BUILDING
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-626-5890
Practice Address - Fax:616-624-6181
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN185522084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology