Provider Demographics
NPI:1720082787
Name:ADAMS, KENNETH G (MD)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:G
Last Name:ADAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 PARKWAY
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6278
Mailing Address - Country:US
Mailing Address - Phone:978-521-3288
Mailing Address - Fax:978-469-5644
Practice Address - Street 1:1 PARKWAY
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6278
Practice Address - Country:US
Practice Address - Phone:978-521-3270
Practice Address - Fax:978-469-5644
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA49552207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
0011274OtherNEIGHBORHOOD HEALTH PLAN
A160348OtherINTEGRATED HEALTH PLAN
NHB74327OtherANTHEM BLUE CROSS
060061827OtherRAILROAD MEDICARE
MAJ02809OtherBLUE CROSS BLUE SHIELD
MA049552OtherTUFTS HEALTH PLAN
NH00000287OtherNH MEDICAID
MA2186788OtherCIGNA
MA110064339AMedicaid
875007OtherNETWORK HEALTH
MA678820OtherHEALTHSOURCE
1720082787OtherAETNA - HMO
4365257OtherAETNA -- NON-HMO
MA300015OtherHARVARD PILGRIM HEALTHCAR
4365257OtherAETNA -- NON-HMO
MA678820OtherHEALTHSOURCE