Provider Demographics
NPI:1700883535
Name:ADOLPH, JOSEPH F (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:F
Last Name:ADOLPH
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 1:340 MAIN ST
Mailing Address - Street 2:STE. 670
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1604
Mailing Address - Country:US
Mailing Address - Phone:508-754-3566
Mailing Address - Fax:508-798-8012
Practice Address - Street 1:159 UNION ST
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:MA
Practice Address - Zip Code:01752-1274
Practice Address - Country:US
Practice Address - Phone:508-481-0246
Practice Address - Fax:508-229-0949
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA39240208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2044781Medicaid
A34862Medicare UPIN
MAB28044Medicare PIN