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NPI Code Detail

MEDICARE: ADAM CARLTON MCDONOUGH M.D.

MEDICARE: ADAM CARLTON MCDONOUGH M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician2015-02481NC

General Provider Information

NPI Number : 1225349053
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM CARLTON MCDONOUGH M.D.
Provider Business Mailing Address
First Line : 713 S MARSHALL ST
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27101-5808
Country : US
Telephone Number : 336-722-2390
Fax Number : 336-201-0538
Provider Business Practice Location Address
First Line : 1615 POLO RD
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27106-3831
Country : US
Telephone Number : 336-722-7266
Fax Number : 336-201-0538
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2010
Last Update Date : 05/11/2023

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