Provider Demographics
NPI:1700079001
Name:JAMES ADLEBERG DPM, P.A.
Entity type:Organization
Organization Name:JAMES ADLEBERG DPM, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:ADLEBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:410-933-3300
Mailing Address - Street 1:8100 SANDPIPER CIR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236
Mailing Address - Country:US
Mailing Address - Phone:410-933-3300
Mailing Address - Fax:410-933-3303
Practice Address - Street 1:8100 SANDPIPER CIR STE 104
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-5028
Practice Address - Country:US
Practice Address - Phone:410-933-3300
Practice Address - Fax:410-933-3303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01012213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
R841OtherCAREFIRST
MD300403100OtherMEDICAID DME
MD409083700Medicaid
MD480025235OtherMEDICARE RAILROAD
MDCK4820OtherMEDICARE RAILROAD
MD480025235Medicare PIN
MDLV09OtherCAREFIRST
MD480025235OtherMEDICARE RAILROAD