Provider Demographics
NPI:1831164300
Name:WAGSHUL, ADAM D (MD)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:D
Last Name:WAGSHUL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:261 JAMES ST
Mailing Address - Street 2:SUITE 3F
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-538-0029
Mailing Address - Fax:972-538-4957
Practice Address - Street 1:261 JAMES ST
Practice Address - Street 2:SUITE 3F
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-538-0029
Practice Address - Fax:972-538-4957
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07639700207XX0801X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ200421776OtherTIN
NJ084094Medicare ID - Type Unspecified
NJH45366Medicare UPIN