Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DS030396L | PA |
NPI | 1043249915 |
---|---|
Provider Name | Maxwell C. Adams |
First Address | Lancaster, PA 17601-2644 |
Second Address | Lancaster, PA 17601-2644 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2006 |
Last Update Date | 09/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001911723001 | (05) | PA |
01911723 | (05) | PA |
20016597 | AMERIHEALTH MERCY (01) | PA |
50000508 | CAPITAL BLUE CROSS (01) | PA |
6461942001 | CIGNA (01) | PA |
AD1382776 | HIGHMARK BLUE SHIELD (01) | PA |
U90199 | (02) | |
U90199 | (02) | PA |