MEDICARE: JUSTIN LEE ADAME DPM

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	390200000X	Student in an Organized Health Care Education/Training Program		MI
2	213ES0103X	Foot & Ankle Surgery Podiatrist	692123	TX

General Provider Information

NPI Number	:	1841871977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN LEE ADAME DPM

Provider Business Mailing Address
First Line	:	50 N PERRY ST
Second Line	:
City	:	PONTIAC
State	:	MI
Zip	:	48342-2217
Country	:	US
Telephone Number	:	248-338-5392
Fax Number	:

Provider Business Practice Location Address
First Line	:	3301 S ALAMEDA ST STE 306
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78411-1876
Country	:	US
Telephone Number	:	361-884-3984
Fax Number	:	361-452-3262

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

Provider Enumeration Date	:	04/20/2021
Last Update Date	:	06/14/2024

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Directions to “ JUSTIN LEE ADAME DPM” Practice Location

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