Provider Demographics
NPI:1174586135
Name:ADLER, SAMUEL E (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:E
Last Name:ADLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6535 N CHARLES ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-5826
Mailing Address - Country:US
Mailing Address - Phone:410-938-5252
Mailing Address - Fax:410-938-5250
Practice Address - Street 1:2401 W BELVEDERE AVE
Practice Address - Street 2:DEPT OF PSYCHIATRY
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5216
Practice Address - Country:US
Practice Address - Phone:410-601-5461
Practice Address - Fax:410-601-4458
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD00174042084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD154091200Medicaid
MD260031683OtherR/R MEDICARE PROVIDER #
MDD77643Medicare UPIN
MD260031683OtherR/R MEDICARE PROVIDER #
MD154091200Medicaid