Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 35055967A | OH |
Y | 207RA0401X | Internist - Addiction Medicine | 35055967A | OH |
NPI | 1063499598 |
---|---|
Provider Name | Christopher L Adelman |
First Address | Cleveland, OH 44115-3111 |
Second Address | Cleveland, OH 44115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2005 |
Last Update Date | 17/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000135962 | ANTHEM BLUE CROSS (01) | OH |
0679145 | (05) | OH |
930047005 | PALMETTO GBA RETIRED (01) | OH |
A82854 | (02) | OH |