Provider Demographics
NPI:1265425417
Name:ESTEVEZ, ADAM MIGUEL (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:MIGUEL
Last Name:ESTEVEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:605 18TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-4605
Mailing Address - Country:US
Mailing Address - Phone:917-385-6186
Mailing Address - Fax:
Practice Address - Street 1:160 COWLES ST
Practice Address - Street 2:FAIRBANKS MEMORIAL HOSPITAL
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4459
Practice Address - Country:US
Practice Address - Phone:907-458-5525
Practice Address - Fax:907-458-5514
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AK35072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry