MEDICARE: DR. ELVIN EUGENE ADAMS MD/MPH

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	207R00000X	Internal Medicine Physician	F2519	TX
2	207R00000X	Internal Medicine Physician	20993	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	00J33T	OTHER	TX	MEDICARE GROUP #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497752554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELVIN EUGENE ADAMS MD/MPH

Provider Business Mailing Address
First Line	:	1444 S 17TH ST
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28401-6436
Country	:	US
Telephone Number	:	910-793-4311
Fax Number	:	910-793-4322

Provider Business Practice Location Address
First Line	:	1444 S 17TH ST
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28401-6436
Country	:	US
Telephone Number	:	910-793-4311
Fax Number	:	910-793-4322

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	12/17/2018

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