MEDICARE: DR. THERAN BRADFORD ADAMSON MD

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	207QA0401X	Addiction Medicine (Family Medicine) Physician	MD-53395	IA
2	207Q00000X	Family Medicine Physician	M-12662	ID
3	207Q00000X	Family Medicine Physician	39950	CO
4	207QA0401X	Addiction Medicine (Family Medicine) Physician	ME152384	FL

General Provider Information

NPI Number	:	1386646610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THERAN BRADFORD ADAMSON MD

Provider Business Mailing Address
First Line	:	1200 UNIVERSITY AVE STE 200
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50314-2355
Country	:	US
Telephone Number	:	515-248-1447
Fax Number	:	515-248-1440

Provider Business Practice Location Address
First Line	:	1200 UNIVERSITY AVE STE 120
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50314-2355
Country	:	US
Telephone Number	:	515-248-1500
Fax Number	:	515-248-1510

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	08/21/2024

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