Provider Demographics
NPI:1730376831
Name:DAVID B. ADAM, PHD, INC
Entity type:Organization
Organization Name:DAVID B. ADAM, PHD, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:801-566-2622
Mailing Address - Street 1:6925 UNION PARK CTR
Mailing Address - Street 2:SUITE 490
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-4142
Mailing Address - Country:US
Mailing Address - Phone:801-566-2622
Mailing Address - Fax:801-566-0536
Practice Address - Street 1:6925 UNION PARK CTR
Practice Address - Street 2:SUITE 490
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-4142
Practice Address - Country:US
Practice Address - Phone:801-566-2622
Practice Address - Fax:801-566-0536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT108342-2501251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health