Basic Information
Provider Information
NPI: 1871857821
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MEYERS
FirstName: ADAM
MiddleName: J.
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 11314
Address2:  
City: BELFAST
State: ME
PostalCode: 049154004
CountryCode: US
TelephoneNumber: 7578424481
FaxNumber: 7573123135
Practice Location
Address1: 113 GAINSBOROUGH SQ STE 400
Address2:  
City: CHESAPEAKE
State: VA
PostalCode: 233201714
CountryCode: US
TelephoneNumber: 7578424499
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/25/2012
LastUpdateDate: 05/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XA132023CAN Allopathic & Osteopathic PhysiciansSurgery 
208600000X0101267151VAY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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