Provider Demographics
NPI:1659323913
Name:ADELMAN, STEVEN A (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:A
Last Name:ADELMAN
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 1:147 MILK ST
Mailing Address - Street 2:PROVIDER ENROLLMENT 9TH FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-4806
Mailing Address - Country:US
Mailing Address - Phone:617-559-8051
Mailing Address - Fax:
Practice Address - Street 1:291 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-3628
Practice Address - Country:US
Practice Address - Phone:617-541-6575
Practice Address - Fax:617-541-7510
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA496292084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP00016688OtherMEDICARE RAILROAD
MAB07207OtherBLUE CROSS
MA705475OtherTUFTS HEALTH PLAN
MA0017383OtherNEIGHBORHOOD HEALTH PLAN
MAEX8338OtherMEDICARE PTAN
MAB07207OtherBLUE CROSS
MAA33444Medicare PIN