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General NPI Number Information
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NPI Number | 1508985474
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTH AND SPORTS MEDICINE PC
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 301 N 27TH ST SUITE 11
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City | NORFOLK
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State | NE
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Zip | 68701-4457
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Country | US
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Telephone | 402-844-8167
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Fax | 402-844-8168
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Provider Business Mailing Address
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Address Line | 301 N 27TH ST SUITE 11
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City | NORFOLK
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State | NE
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Zip | 68701-4457
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Country | US
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Telephone | 402-844-8167
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Fax | 402-844-8168
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL A ADAMS
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Credential | M.D.
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Telephone | 402-844-8167
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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 | 17698
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License Number State | NE
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