Provider Demographics
NPI:1912340597
Name:WOELK, ADAM LEE (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:LEE
Last Name:WOELK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1299 KEKUANAOA ST UNIT 5482
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-0138
Mailing Address - Country:US
Mailing Address - Phone:907-744-6443
Mailing Address - Fax:
Practice Address - Street 1:602 CHASE AVE
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:AK
Practice Address - Zip Code:99547
Practice Address - Country:US
Practice Address - Phone:907-424-8200
Practice Address - Fax:907-424-8203
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100992207Q00000X
HIMD-20461208D00000X, 207Q00000X
AK131028207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice