Provider Demographics
NPI:1730395088
Name:ADAMS, JUDITH ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:ANNE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:432 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-4004
Mailing Address - Country:US
Mailing Address - Phone:215-925-2400
Mailing Address - Fax:215-925-9162
Practice Address - Street 1:1408 S BROAD ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-4808
Practice Address - Country:US
Practice Address - Phone:215-755-0700
Practice Address - Fax:215-755-6474
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD027884E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1107914Medicaid
184472OtherBCBS
C33024Medicare UPIN
PA1107914Medicaid