Provider Demographics
NPI:1912998915
Name:GARRETSON, ADAM D (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:D
Last Name:GARRETSON
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 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:325B KING STREET
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2370
Practice Address - Country:US
Practice Address - Phone:413-387-4100
Practice Address - Fax:413-387-4119
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA208867207Q00000X, 207R00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD521116591OtherCOVENTRY
MD766634OtherNCPPO
A3195601Medicare PIN
MD2157633OtherMAMSI/ALLIANCE
MD3443400OtherCIGNA
MD521116591OtherMARYLAND PHYSICIANS CARE
MD7061228OtherAETNA
MDP17329OtherCAREFIRST BC/BS POS
MD8157633OtherOPTIMUM CHOICE/MDIPA
MD521116591OtherTRICARE
MD89185201OtherCAREFIRST BC/BS RENDERING
MDS135P172Medicare PIN
MDT5880035OtherCF BC/BS GRP/GHMSI/BL CHO
H10963Medicare UPIN
MD112727OtherPRIORITY PARTNERS
MD521116591OtherINFORMED
MD784381000Medicaid