Healthcare Provider Details

I. General information

NPI: 1396184859
Provider Name (Legal Business Name): NICHOLAS STEVEN ADAMS M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2013
Last Update Date: 07/19/2025
Certification Date: 07/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 49TH ST S
FARGO ND
58104
US

IV. Provider business mailing address

3171 44TH ST S UNIT 101
FARGO ND
58104-8521
US

V. Phone/Fax

Practice location:
  • Phone: 701-412-2400
  • Fax: 701-941-7606
Mailing address:
  • Phone: 701-412-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberPT-16265
License Number StateND

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: