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General NPI Number Information
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NPI Number | 1205013455
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Entity Type | Organization
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Legal Business Name | MICHAEL D. ADAMS, M.D., P.C.
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Dates
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Enumeration Date | 01/29/2008
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Last Update Date | 10/25/2011
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Provider Practice Location Address
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Address Line | 75 YELLOW CREEK RD SUITE 102
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City | EVANSTON
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State | WY
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Zip | 82930-5235
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Country | US
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Telephone | 307-789-8290
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Fax | 307-789-8290
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Provider Business Mailing Address
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Address Line | 75 YELLOW CREEK RD SUITE 102
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City | EVANSTON
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State | WY
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Zip | 82930-5235
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Country | US
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Telephone | 307-789-8290
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Fax | 307-789-8290
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Authorized Official
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Title or Position | OPERATIONS SUPERVISOR
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Name | NIKKI OLDHAM
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Credential |
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Telephone | 435-755-6061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4371-A
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License Number State | WY
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