Provider Demographics
NPI:1306944111
Name:ADAMITIS, JOSEPH (DPM)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:ADAMITIS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 178
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:PA
Mailing Address - Zip Code:19033-0178
Mailing Address - Country:US
Mailing Address - Phone:215-483-2300
Mailing Address - Fax:215-483-4414
Practice Address - Street 1:5830 HENRY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128
Practice Address - Country:US
Practice Address - Phone:215-483-2300
Practice Address - Fax:215-483-4414
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2011-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003704L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017969800003Medicaid
PA480032876OtherRAILROAD
PA650399333000OtherKEYSTONE
PA510975Medicare ID - Type Unspecified
PA0017969800003Medicaid