Provider Demographics
NPI:1063437358
Name:ADAMO, CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:
Last Name:ADAMO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 HOWARD RD
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-4721
Mailing Address - Country:US
Mailing Address - Phone:410-295-3383
Mailing Address - Fax:
Practice Address - Street 1:2629 RIVA RD
Practice Address - Street 2:SIOTE 112
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7428
Practice Address - Country:US
Practice Address - Phone:410-266-1000
Practice Address - Fax:410-573-4028
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0018566207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0099OtherCAREFIRST DC
2108409OtherAETNA HMO
MD283144OtherMAMSI
5409729OtherAATNA PPO
MD0101535Medicaid
110093OtherCOVENTRY
MD099517OtherJOHNS HOPKINS HEALTHCARE
1808419OtherUNITED HEALTHCARE
9956OtherKAISER
35210101OtherCAREFIRST MARYLAND
MD95694Medicaid
9985122001OtherCIGNA
700247OtherNCPPO
C49062Medicare UPIN
81WWMedicare ID - Type Unspecified