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General NPI Number Information
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NPI Number | 1386646610
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Entity Type | Individual
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Provider Name | THERAN BRADFORD ADAMSON MD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 1200 UNIVERSITY AVE STE 120
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City | DES MOINES
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State | IA
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Zip | 50314-2355
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Country | US
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Telephone | 515-248-1500
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Fax | 515-248-1510
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Provider Business Mailing Address
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Address Line | 1200 UNIVERSITY AVE STE 200
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City | DES MOINES
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State | IA
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Zip | 50314-2355
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Country | US
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Telephone | 515-248-1447
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Fax | 515-248-1440
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | MD-53395
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M-12662
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 39950
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | ME152384
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License Number State | FL
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