MEDICARE: DR. MICHAEL MARK ADAMS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	195348	NY

General Provider Information

NPI Number	:	1275662801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL MARK ADAMS M.D.

Provider Business Mailing Address
First Line	:	133 W 71ST ST
Second Line	:	APT 5C
City	:	NEW YORK
State	:	NY
Zip	:	10023-3834
Country	:	US
Telephone Number	:	212-874-0268
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 RIVERSIDE DR
Second Line	:	SUITE 1E
City	:	NEW YORK
State	:	NY
Zip	:	10024-3710
Country	:	US
Telephone Number	:	917-543-5645
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	07/08/2007

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