Provider Demographics
NPI:1720051154
Name:RICHARD D ADELMAN MD
Entity type:Organization
Organization Name:RICHARD D ADELMAN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:ADELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-846-9292
Mailing Address - Street 1:7320 SIX FORKS RD
Mailing Address - Street 2:STE 260
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-5284
Mailing Address - Country:US
Mailing Address - Phone:919-846-9292
Mailing Address - Fax:919-848-3638
Practice Address - Street 1:7320 SIX FORKS RD
Practice Address - Street 2:STE 260
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615
Practice Address - Country:US
Practice Address - Phone:919-846-9292
Practice Address - Fax:919-848-3638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8910394Medicaid
NC10394OtherBCBSNC
NC10394OtherBCBSNC
NC8910394Medicaid