Provider Demographics
NPI:1720463656
Name:BOX, ADRIAN (MD)
Entity type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:
Last Name:BOX
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 1:3085 COLONIAL WAY APT A
Mailing Address - Street 2:
Mailing Address - City:CHAMBLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30341-5332
Mailing Address - Country:US
Mailing Address - Phone:404-712-2753
Mailing Address - Fax:
Practice Address - Street 1:3085 COLONIAL WAY APT A
Practice Address - Street 2:
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341-5332
Practice Address - Country:US
Practice Address - Phone:404-712-2753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008137207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology