Provider Demographics
NPI:1205893161
Name:ADAM, JAMIE L (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:L
Last Name:ADAM
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-3100
Mailing Address - Country:US
Mailing Address - Phone:570-321-3780
Mailing Address - Fax:
Practice Address - Street 1:740 E STATE ST
Practice Address - Street 2:SHARON REGIONAL HEALTH SYSTEM LAB
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-3328
Practice Address - Country:US
Practice Address - Phone:724-983-3952
Practice Address - Fax:724-983-3941
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425815207ZP0105X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1014152720001Medicaid
3409529OtherAETNA HMO PATHOLOGY GROUP
237937OtherHEALTH AMER/HLTH ASSURANC
250979377062OtherCONSUMERS LIFE PATH GROUP
P00259470OtherRAILROAD MEDICARE
PA1765796OtherHIGHMARK BLUE SHIELD
OH2620177Medicaid
1024665OtherGATEWAY (GROUP NUMBER)
1919857OtherCIGNA
PA7938563OtherAETNA PPO PATHOLOGY GROUP
OH000000376940OtherANTHEM BC & BS OF OHIO
250979377062OtherCONSUMERS LIFE PATH GROUP
1919857OtherCIGNA