Healthcare Provider Details

I. General information

NPI: 1518948710
Provider Name (Legal Business Name): MR. JAMES ALBERT ADAMEC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18TH MEDCOM ATTN: 1)CCS-AM(CREDENTIALS)
APO AP
96205-0054
KR

IV. Provider business mailing address

18TH MEDCOM ATTN: 1)CCS-AM(CREDENTIALS)
APO AP
96205-0054
KR

V. Phone/Fax

Practice location:
  • Phone: 01182279166027
  • Fax: 01182279178110
Mailing address:
  • Phone: 01182279166027
  • Fax: 01182279178110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN00127205
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: