Organization
INNOVATIVE PHYSICIAN SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADNAN M DAHDUL M.D. (OWNER/CEO/OFFICER)
(413) 301-6019
Entity
Organization
Contact information
Practice address
490 PAGE BOULEVARD, SPRINGFIELD, MA 01104
(413) 349-5063
(413) 363-2857
Mailing address
95 FRANK B MURRAY ST, SPRINGFIELD, MA 01103-1106
(413) 301-6019
(413) 363-2857
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
111N00000X
Chiropractor
—
—
207R00000X
Internal Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
225100000X
Physical Therapist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110068493C
—
MA
05
—
118236600
—
FL
05
—
30214102
—
NH
01
—
4D55
DPH LICENSE
MA
05
—
9721690
—
MA
01
—
M18224
BLUE CROSS
MA
Enumeration date
10/12/2005
Last updated
08/06/2025
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