Provider Demographics
NPI:1831148840
Name:MCADAM, FREDERICK B (MD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:B
Last Name:MCADAM
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 1:100 COLLEGE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6800
Mailing Address - Country:US
Mailing Address - Phone:716-626-0093
Mailing Address - Fax:716-626-9193
Practice Address - Street 1:100 COLLEGE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6800
Practice Address - Country:US
Practice Address - Phone:716-626-0093
Practice Address - Fax:716-626-9193
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY161215208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01080060Medicaid
NYB71416Medicare UPIN
NY01080060Medicaid