Provider Demographics
NPI:1841299278
Name:ADAS, ROBERT DONALD (DPM)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:DONALD
Last Name:ADAS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33566 W 8 MILE RD
Mailing Address - Street 2:STE C
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-5271
Mailing Address - Country:US
Mailing Address - Phone:248-478-6870
Mailing Address - Fax:248-851-0173
Practice Address - Street 1:33566 W 8 MILE RD
Practice Address - Street 2:STE C
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-5271
Practice Address - Country:US
Practice Address - Phone:248-478-6870
Practice Address - Fax:248-851-0173
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRA000922213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1392513Medicaid
MI4647030001OtherMEDICARE DME
MIT34120OtherHAP
MI5635014OtherBLUE CROSS BLUE SHIELD
MI1392513Medicaid
MIT34120Medicare UPIN