Healthcare Provider Details

I. General information

NPI: 1114678364
Provider Name (Legal Business Name): CLAY STEVEN ADAMS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2022
Last Update Date: 01/11/2022
Certification Date: 01/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 W GREENLAWN AVE STE 200
LANSING MI
48910-2889
US

IV. Provider business mailing address

6398 SLEIGHT RD
BATH MI
48808-9485
US

V. Phone/Fax

Practice location:
  • Phone: 517-657-2638
  • Fax: 248-711-2438
Mailing address:
  • Phone: 517-898-1260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: