Innovative Physician Services Llc

LBN: Innovative Physician Services Llc
Innovative Physician Services Llc is an health care organization with primary practice located at 490 Page Boulevard , Springfield MA 01104. The organization recently has 8 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Chiropractic Providers / Chiropractor, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is the primary health care specialty. Innovative Physician Services Llc can be contacted via phone (413) 349-5063, or through Dahdul, Adnan M via phone (413) 301-6019.

Contact Information

Primary practice address
490 Page Boulevard Springfield MA 01104
Phone: (413) 349-5063
Fax: (413) 363-2857
Website:
Map and Directions
Authorized official contact:
Name: Dahdul, Adnan M Doctor of Medicine (MD)
Phone: (413) 301-6019

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Chiropractic Providers / Chiropractor 111N00000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X

Profile Details

NPI number 1922096049
LBN Legal business name Innovative Physician Services Llc
DBA Doing business as
Authorized official Dahdul, Adnan M Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 12th, 2005
Last updated Feb 1st, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922096049 NPPES
Massachusetts MEDICAID 110068493C
Massachusetts MEDICAID 30214102
Massachusetts Other M18224
Massachusetts MEDICAID 9721690
Massachusetts MEDICAID 118236600

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