Provider Demographics
NPI:1134191224
Name:ADAMS, RUSSELL LIBIORE (DO)
Entity type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:LIBIORE
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 CLIFFMINE RD SUITE 110
Mailing Address - Street 2:PARKWEST ONE
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15275
Mailing Address - Country:US
Mailing Address - Phone:412-722-0102
Mailing Address - Fax:412-722-0106
Practice Address - Street 1:1000 CLIFFMINE RD SUITE 110
Practice Address - Street 2:PARKWEST ONE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15275
Practice Address - Country:US
Practice Address - Phone:412-722-0102
Practice Address - Fax:412-722-0106
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS19264207QA0401X
OH34.008291207QS0010X
NJ25MB07991400207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1010875560002Medicaid
OHH94361Medicare UPIN
PAH94361Medicare UPIN