Provider Demographics
NPI:1700812237
Name:ADAM, MARGARET R (MD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:R
Last Name:ADAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EMBARCADERO CTR STE 1900
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-3723
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:617-701-7740
Practice Address - Street 1:64 RAINIER AVE S
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057
Practice Address - Country:US
Practice Address - Phone:425-224-2144
Practice Address - Fax:425-341-9653
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0071923207R00000X
MA1017900207R00000X
AZ70648207R00000X
WAMD00034792207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0039581OtherLABOR & INDUSTRY
110211793OtherRAILROAD MEDICARE
WAAD2541OtherBLUE SHIELD
WA8246985Medicaid
WAUS4508822OtherAETNA/USHC SPECIALIST
110211793OtherRAILROAD MEDICARE
WA8246985Medicaid
WA0039581OtherLABOR & INDUSTRY
WAG8898768Medicare PIN
8800985Medicare ID - Type Unspecified
WA8897396Medicare PIN