Provider Demographics
NPI:1316926769
Name:FENWICK, JAMES ADAM (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ADAM
Last Name:FENWICK
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 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-4090
Mailing Address - Fax:717-812-4092
Practice Address - Street 1:207 BLOOMING GROVE RD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-7917
Practice Address - Country:US
Practice Address - Phone:717-812-7559
Practice Address - Fax:717-632-2422
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD069752L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30120301OtherAMERIHEALTH MERCY - WMG
PA1578277OtherGATEWAY
PA001882443Medicaid
PA1376033OtherHIGHMARK BLUE SHIELD
PA055613FLTMedicare PIN