Individual
ADAM STEVEN HIMEBAUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3401 CIVIC CENTER BLVD STE 7C26, PHILADELPHIA, PA 19104-4319
(215) 590-1858
(215) 590-5574
Mailing address
3401 CIVIC CENTER BLVD STE 9329, PHILADELPHIA, PA 19104-4319
(267) 425-9300
(267) 425-9331
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD431966
PA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
MD431966
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027396220001
—
PA
01
—
244840EMD
MEDICARE PTAN
PA
Enumeration date
06/29/2007
Last updated
06/02/2023
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