Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | D0071452 | MD |
Y | 2080P0208X | Pediatric Infectious Diseases | D0071452 | MD |
NPI | 1356679831 |
---|---|
Provider Name | Mr. Daniel Justin Adams |
First Address | Portsmouth, VA 23708 |
Second Address | Portsmouth, VA 23708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2009 |
Last Update Date | 19/06/2017 |