Provider Demographics
NPI:1639605389
Name:SAWYER, ADAM FREDRICK (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:FREDRICK
Last Name:SAWYER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 KEPLER DR
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-8321
Mailing Address - Country:US
Mailing Address - Phone:920-288-5500
Mailing Address - Fax:920-288-5510
Practice Address - Street 1:1160 KEPLER DR
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-8321
Practice Address - Country:US
Practice Address - Phone:920-288-5500
Practice Address - Fax:920-288-5510
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301501816208000000X
WI84796-20208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics