Provider Demographics
NPI:1366738569
Name:RODRIGUEZ, ADAM RAY (DO)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:RAY
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20366 ORCHARD GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3529
Mailing Address - Country:US
Mailing Address - Phone:757-621-8833
Mailing Address - Fax:
Practice Address - Street 1:600 GRESHAM DR FL 5
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1904
Practice Address - Country:US
Practice Address - Phone:757-388-3198
Practice Address - Fax:757-388-4242
Is Sole Proprietor?:No
Enumeration Date:2011-06-26
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-01578207R00000X, 208M00000X
VA0102207920207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine