Healthcare Provider Details

I. General information

NPI: 1073956231
Provider Name (Legal Business Name): ZACHARY ALEXIS ADAMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2013
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4245 JOHNS CREEK PKWY STE A
SUWANEE GA
30024-9122
US

IV. Provider business mailing address

100 KIMBALL PL STE 100
ALPHARETTA GA
30009-2614
US

V. Phone/Fax

Practice location:
  • Phone: 678-990-3962
  • Fax: 678-623-3862
Mailing address:
  • Phone: 678-990-3962
  • Fax: 678-623-3862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number60894787
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License NumberA167567
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number103478
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: