MEDICARE: DR. WAYNE D 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	2085R0202X	Diagnostic Radiology Physician	M-10337	ID
2	2085R0202X	Diagnostic Radiology Physician	183203-1205	UT

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

General Provider Information

NPI Number	:	1588665301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WAYNE D ADAMS M.D.

Provider Business Mailing Address
First Line	:	5217 S STATE ST STE 200
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84107-4812
Country	:	US
Telephone Number	:	801-313-4112
Fax Number	:	801-313-4128

Provider Business Practice Location Address
First Line	:	5121 S COTTONWOOD ST
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84107-5701
Country	:	US
Telephone Number	:	801-507-7000
Fax Number	:

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

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	10/11/2022

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