Provider Demographics
NPI:1285724351
Name:PRITZKER, ADAM SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:SCOTT
Last Name:PRITZKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:712 E 70TH ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4811
Mailing Address - Country:US
Mailing Address - Phone:912-352-8974
Mailing Address - Fax:912-355-8329
Practice Address - Street 1:712 E 70TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4811
Practice Address - Country:US
Practice Address - Phone:912-352-8974
Practice Address - Fax:912-355-8329
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA048454207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH14604Medicare UPIN
GA08BBVVJMedicare ID - Type Unspecified