Provider Demographics
NPI:1205164761
Name:WARREN, ADAM PAUL CARTER (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:PAUL CARTER
Last Name:WARREN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4096 PIEDMONT AVE # 301
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5221
Mailing Address - Country:US
Mailing Address - Phone:877-400-0128
Mailing Address - Fax:510-400-5118
Practice Address - Street 1:5700 TELEGRAPH AVE STE 100
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1710
Practice Address - Country:US
Practice Address - Phone:877-400-0128
Practice Address - Fax:510-400-5118
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA103633207X00000X, 207XX0801X
PAMD446107207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD055447200Medicaid
PA1610980OtherGATEWAY
PA30120394OtherAMERIHEALTH MERCY - WMG
PA418504OtherUPMC
PA2716643OtherHIGHMARK BLUE SHIELD
PA102733306Medicaid
PA30120394OtherAMERIHEALTH MERCY - WMG