Healthcare Provider Details
I. General information
NPI: 1134668056
Provider Name (Legal Business Name): BRYAN GREGORY ADAMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/13/2017
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
LANDSTUHL REGIONAL MEDICAL CENTER DR. HITZELBERGER STRASSE, ATTN: DR. BRYAN ADAMS (ORTHO)
LANDSTUHL RHEINLAND-PFALZ
66849
DE
IV. Provider business mailing address
LANDSTUHL REGIONAL MEDICAL CENTER DR. HITZELBERGER STRASSE, ATTN: DR. BRYAN ADAMS (ORTHO)
LANDSTUHL RHEINLAND-PFALZ
66849
DE
V. Phone/Fax
- Phone: 314-590-5762
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 31215 |
| License Number State | NE |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XX0005X |
| Taxonomy | Sports Medicine (Orthopaedic Surgery) Physician |
| License Number | 31215 |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: