Provider Demographics
NPI:1104879501
Name:PERZIN, ADAM DEAN (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:DEAN
Last Name:PERZIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:15000 MIDLANTIC DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1573
Mailing Address - Country:US
Mailing Address - Phone:856-252-1000
Mailing Address - Fax:856-252-1100
Practice Address - Street 1:15000 MIDLANTIC DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1573
Practice Address - Country:US
Practice Address - Phone:856-252-1000
Practice Address - Fax:856-252-1100
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05964300208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7196202Medicaid
NJ894049Medicare ID - Type UnspecifiedMEDICARE
NJ7196202Medicaid