Provider Demographics
NPI:1457699597
Name:MIRAMON, ADAM DEWALD (DACM, DIPLAC, LAC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:DEWALD
Last Name:MIRAMON
Suffix:
Gender:M
Credentials:DACM, DIPLAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 CONNECTICUT AVENUE NW, 3RD FLOOR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-1054
Mailing Address - Country:US
Mailing Address - Phone:202-297-7404
Mailing Address - Fax:202-478-2633
Practice Address - Street 1:1645 CONNECTICUT AVENUE NW, 3RD FLOOR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-1054
Practice Address - Country:US
Practice Address - Phone:202-297-7404
Practice Address - Fax:202-478-2633
Is Sole Proprietor?:No
Enumeration Date:2013-01-24
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02029171100000X
VA0191000902171100000X
DECT-0000003171100000X
DCAC500161171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist