Provider Demographics
NPI:1104928340
Name:ADACHI, MARI (MD)
Entity type:Individual
Prefix:
First Name:MARI
Middle Name:
Last Name:ADACHI
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 1:4716 ALLIANCE BLVD STE 700
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5389
Mailing Address - Country:US
Mailing Address - Phone:469-800-6000
Mailing Address - Fax:469-800-6030
Practice Address - Street 1:4716 ALLIANCE BLVD STE 700
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5389
Practice Address - Country:US
Practice Address - Phone:469-800-6000
Practice Address - Fax:469-800-6030
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ2422207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
043789OtherCONNECTICARE
2V7933OtherHEALTH NET
010043789CT01OtherBLUE SHIELD OF CONNECTICU
2V7933OtherHEALTH NET