Provider Demographics
NPI:1801886262
Name:MAGNUS, ADAM CHARLES (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:CHARLES
Last Name:MAGNUS
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:HANOVER ANESTHESIA AND PAIN MANAGEMENT
Mailing Address - Street 2:250 FAME AVENUE # 110
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331
Mailing Address - Country:US
Mailing Address - Phone:717-632-9955
Mailing Address - Fax:
Practice Address - Street 1:420 S 5TH AVE
Practice Address - Street 2:
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-2143
Practice Address - Country:US
Practice Address - Phone:484-628-8269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0057163207L00000X, 207LP2900X
PAMD436288207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCS417 0003OtherCAREFIRST BCBS (DC)
MD699338900Medicaid
MD613896 04OtherCAREFIRST BCBS MD
MDKBC1CHOtherCAREFIRST BCBS (MD)
MDP00130964OtherRR MEDICARE (GRP PTAN CJ8689)
MDP00790023OtherRR MEDICARE (GRP PTAN DD6120)
MDKBC1CHOtherCAREFIRST BCBS (MD)
H41019Medicare UPIN
MD699338900Medicaid