Provider Demographics
NPI:1871537514
Name:ADAM, PATRICIA (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:ADAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 E 28TH ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1394
Mailing Address - Country:US
Mailing Address - Phone:612-333-0770
Mailing Address - Fax:612-333-1986
Practice Address - Street 1:2020 E 28TH ST.
Practice Address - Street 2:UMPHYSICIANS SMILEY'S CLINIC
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407
Practice Address - Country:US
Practice Address - Phone:612-333-0770
Practice Address - Fax:612-333-1986
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN36941207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN01-15514OtherMEDICA CHOICE & PRIMARY
MN120407OtherUCARE
MN767987OtherARAZ
SD7777470Medicaid
IA1543538Medicaid
MN04R41ADOtherBCBS
MNHP21958OtherHEALTHPARTNERS
WI32039900Medicaid
MN1012184OtherPREFERRED ONE
MN226718700Medicaid
ND10387Medicaid
MN1012184OtherPREFERRED ONE