Provider Demographics
NPI:1588114029
Name:DONNELLY, ADAM TEIGI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:TEIGI
Last Name:DONNELLY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4531 COTTENDALE DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-6243
Mailing Address - Country:US
Mailing Address - Phone:919-592-8016
Mailing Address - Fax:
Practice Address - Street 1:805 S LONG DR
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-4317
Practice Address - Country:US
Practice Address - Phone:910-997-4471
Practice Address - Fax:910-997-4951
Is Sole Proprietor?:No
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26494183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist