Provider Demographics
NPI:1720375520
Name:STURDAVANT, ADAM CLAYTON (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:CLAYTON
Last Name:STURDAVANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11943 EL CAMINO REAL STE 210
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2597
Mailing Address - Country:US
Mailing Address - Phone:858-793-1011
Mailing Address - Fax:858-793-1035
Practice Address - Street 1:11943 EL CAMINO REAL STE 210
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2597
Practice Address - Country:US
Practice Address - Phone:858-793-1011
Practice Address - Fax:858-793-1035
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL125060544208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics