Provider Demographics
NPI:1942463799
Name:BELL, ADAM D (DO)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:D
Last Name:BELL
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:PO BOX 742941
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-2941
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:315 E ELM ST STE 350
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-4881
Practice Address - Country:US
Practice Address - Phone:208-459-0028
Practice Address - Fax:208-504-4311
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDO-0733208600000X, 208600000X
MI5101017597208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1942463799OtherREGENCE BLUE SHIELD
ID1942463799Medicaid
ID2029364OtherBLUE CROSS
WA1942463799Medicaid
ID2029364OtherBLUE CROSS
ID0318263OtherWA L & INDUSTRIES
ID20003125Medicare PIN