Provider Demographics
NPI:1295977783
Name:SHREWSBERRY, ADAM B (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:B
Last Name:SHREWSBERRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 HOSPITAL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37760-5204
Mailing Address - Country:US
Mailing Address - Phone:865-647-1876
Mailing Address - Fax:865-471-2246
Practice Address - Street 1:120 HOSPITAL DR STE 100
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37760-5204
Practice Address - Country:US
Practice Address - Phone:865-647-1876
Practice Address - Fax:865-471-2246
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TN51315208800000X, 174400000X
GA003655208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No174400000XOther Service ProvidersSpecialist