Provider Demographics
NPI:1942448782
Name:SPRAGUE, ADAM A (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:A
Last Name:SPRAGUE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 MAIN ST
Mailing Address - Street 2:SUITE 1007
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01103-1628
Mailing Address - Country:US
Mailing Address - Phone:413-495-1129
Mailing Address - Fax:413-827-7407
Practice Address - Street 1:1350 MAIN ST
Practice Address - Street 2:SUITE 1007
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-1628
Practice Address - Country:US
Practice Address - Phone:413-495-1129
Practice Address - Fax:413-827-7407
Is Sole Proprietor?:No
Enumeration Date:2009-02-02
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA3725363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant