Provider Demographics
NPI:1861794950
Name:OVERGAARD, ADAM JOSEPH (PHARMD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:JOSEPH
Last Name:OVERGAARD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10730 PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2683
Mailing Address - Country:US
Mailing Address - Phone:704-845-2742
Mailing Address - Fax:704-845-4532
Practice Address - Street 1:10730 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2683
Practice Address - Country:US
Practice Address - Phone:704-845-2742
Practice Address - Fax:704-845-4532
Is Sole Proprietor?:No
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21013183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist