Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | PO4033 | FL |
N | 222Z00000X | Podiatrist | PO4033 | FL |
Y | 213E00000X | Podiatrist | POD1107 | ME |
Y | 222Z00000X | Podiatrist | POD1107 | ME |
NPI | 1063892990 |
---|---|
Provider Name | Dr. Adam Simmons |
First Address | Eastport, ME 04631-1306 |
Second Address | Machias, ME 04654 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2015 |
Last Update Date | 22/03/2019 |