Doctor Name: | ADAM ELIAS DULAK |
NPI Number: | 1548515059 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | MA055593 |
Business Practice Address: | 1000 East Mountain Blvd. Wilkes-barre, PA - 187113420 |
Business Phone Number: | 5708087762 |
Business Fax Number: | 5708086128 |
Mailing Address: | 100 North Academy Ave., DANVILLE |
State: | PA |
Postal Code: | 178224903 |
Phone Number: | 5702716144 |
Fax Number: | |
NPI Enumeration Date: | 07/20/2012 |
NPI Last Update Date: | 03/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | MA055593 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |