MEDICARE: DAVID ADAMS MINISTER

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
1	101YP1600X	Pastoral Counselor		OH

General Provider Information

NPI Number	:	1225685506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID ADAMS MINISTER

Provider Business Mailing Address
First Line	:	89 WILLIS ST UNIT 37079
Second Line	:
City	:	MAPLE HEIGHTS
State	:	OH
Zip	:	44137-9504
Country	:	US
Telephone Number	:	440-253-9592
Fax Number	:	216-820-4445

Provider Business Practice Location Address
First Line	:	3704 WALTON AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-4917
Country	:	US
Telephone Number	:	216-407-8431
Fax Number	:	216-820-4445

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2019
Last Update Date	:	08/21/2019

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Directions to “ DAVID ADAMS MINISTER” Practice Location

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