MEDICARE: TIMOTHY A MCADAMS CRNA

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	367500000X	Certified Registered Nurse Anesthetist	APN2791	SC

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	:	1821065202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY A MCADAMS CRNA

Provider Business Mailing Address
First Line	:	894 TREASURY BEND DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29412-9042
Country	:	US
Telephone Number	:	843-367-8234
Fax Number	:

Provider Business Practice Location Address
First Line	:	1072 WILDWOOD CENTRE DR
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29229-8420
Country	:	US
Telephone Number	:	803-788-1120
Fax Number	:

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

Provider Enumeration Date	:	03/03/2006
Last Update Date	:	01/13/2014

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