Provider Demographics
NPI:1134188659
Name:VERNADAKIS, ADAM JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:JAMES
Last Name:VERNADAKIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:41 MALL RD
Mailing Address - Street 2:LAHEY CLINIC, INC - PLASTIC SURGERY
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:781-744-8582
Mailing Address - Fax:781-744-1052
Practice Address - Street 1:41 MALL RD
Practice Address - Street 2:LAHEY CLINIC, INC. - PLASTIC SURGERY
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805-0001
Practice Address - Country:US
Practice Address - Phone:781-744-8582
Practice Address - Fax:781-744-1052
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA206993208200000X, 2082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2008572Medicaid
MARX2169Medicare PIN
MAA36059Medicare PIN
MAH95138Medicare UPIN