Provider Demographics
NPI:1841290962
Name:WASSERMAN, ADAM IRA (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:IRA
Last Name:WASSERMAN
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 1:300 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-2297
Mailing Address - Country:US
Mailing Address - Phone:717-316-3711
Mailing Address - Fax:
Practice Address - Street 1:524 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2594
Practice Address - Country:US
Practice Address - Phone:717-334-2183
Practice Address - Fax:717-334-5246
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042602L207P00000X, 208M00000X
PABW2398546207Q00000X, 208M00000X
PAMD-042602L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA207323OtherJOHNS HOPKINS
PA241001OtherUNISON-WMG
PA38232OtherGEISINGER HEALTH PLAN
PA4263205OtherAETNA
PA20075817OtherAMERIHEALTH MERCY-WMG
PA631146OtherHIGHMARK BLUE SHIELD
PA1222003 03Medicaid
PA1529688OtherGATEWAY-WMG
PA50078244OtherCAPITAL BLUE CROSS-WMG
MD932162OtherCAREFIRST MD BCBS
PA38232OtherGEISINGER HEALTH PLAN
PA631146FLTMedicare PIN
PA50078244OtherCAPITAL BLUE CROSS-WMG