Provider Demographics
NPI:1174536841
Name:ADACHI MEDICAL ASSOCIATES, P.A.
Entity type:Organization
Organization Name:ADACHI MEDICAL ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TARO
Authorized Official - Middle Name:J
Authorized Official - Last Name:ADACHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-332-1521
Mailing Address - Street 1:301 ST. PAUL PLACE
Mailing Address - Street 2:SUITE 603
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202
Mailing Address - Country:US
Mailing Address - Phone:410-332-1521
Mailing Address - Fax:410-752-8495
Practice Address - Street 1:301 ST. PAUL PLACE
Practice Address - Street 2:SUITE 603
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2165
Practice Address - Country:US
Practice Address - Phone:410-332-1521
Practice Address - Fax:410-752-8495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0041017207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD533865OtherALLIANCE
MDW0280001OtherBLUECHOICE
MD589081100Medicaid
MH0233779006OtherCIGNA
MD107649OtherCOVENTRY
MD4604839OtherAETNA
MD533865OtherMAMSI/MDIPA/OPT CHOICE
MDW0A67TJOtherBC/BS
MD4604839OtherAETNA
MD589081100Medicaid