MEDICARE: CARL W ADAMS 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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	25755	CO

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	:	1669433751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARL W ADAMS MD

Provider Business Mailing Address
First Line	:	1600 N GRAND AVE
Second Line	:	SUITE 500
City	:	PUEBLO
State	:	CO
Zip	:	81003-2700
Country	:	US
Telephone Number	:	719-545-0663
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 N GRAND AVE
Second Line	:	SUITE 500
City	:	PUEBLO
State	:	CO
Zip	:	81003-2700
Country	:	US
Telephone Number	:	719-545-0663
Fax Number	:

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

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	07/09/2007

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Directions to “ CARL W ADAMS MD” Practice Location

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