Individual provider Active NPI

Razvan Adam, MD

  • Psychiatry Physician
National Provider Identifier
1124118955
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301062869 Issued in MI
Practice address
PSC 41
Box 883
Apo, AE 09464-0089
Phone
(314) 226-8603
NPI assigned
Oct 13, 2006
Last updated
Apr 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301062869 MI Primary
Child & Adolescent Psychiatry Physician 2084P0804X 4301062869 MI

Addresses

Primary practice location

PSC 41
Box 883
Apo, AE 09464-0089

Mailing address

2699 Antietam CT
Ann Arbor, MI 48105-1456
Phone (989) 423-0672

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301062869MIMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shiawassee County Community Mental Health Authority CurrentSince Oct 1, 2008 Accepting new patients
Community Mental Health for Central Michigan Psychiatry CurrentSince Nov 24, 2019 Accepting new patients
Mra Psychiatrics, PC PastSince Feb 8, 2006 Accepting new patients
Ionia County Community Mental Health Past Accepting new patients

Locations

301 S Crapo St
Ste 100
Mt Pleasant, MI 48858
Phone (989) 772-5938

301 S Crapo St
Ste 200
Mt Pleasant, MI 48858
Phone (989) 772-5938

1555 Industrial Dr
Owosso, MI 48867
Phone (989) 723-0732

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17142/brand/1/csg/1/fhir/r4

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1124118955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2699 ANTIETAM CT",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051456",
            "telephone_number": "989-423-0672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "MIL",
            "address_1": "PSC 41",
            "address_2": "BOX 883",
            "city": "APO",
            "state": "AE",
            "postal_code": "094640089",
            "telephone_number": "314-226-8603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAM",
        "first_name": "RAZVAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301062869",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MI",
            "license": "4301062869",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.