Provider Demographics
NPI:1043024870
Name:HIDAD, ADAM G (BS)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:G
Last Name:HIDAD
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 37TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2249
Mailing Address - Country:US
Mailing Address - Phone:708-800-8158
Mailing Address - Fax:
Practice Address - Street 1:2105 37TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2249
Practice Address - Country:US
Practice Address - Phone:708-800-8158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-03
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program