MEDICARE: MR. CHARLES MICHAEL ADAMS SR. 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	174400000X	Specialist	15436	AL

General Provider Information

NPI Number	:	1902882319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHARLES MICHAEL ADAMS SR. M.D.

Provider Business Mailing Address
First Line	:	2700 HIGHWAY 280 EAST
Second Line	:	SUITE 212
City	:	BIRMINGHAM
State	:	AL
Zip	:	35223
Country	:	US
Telephone Number	:	205-879-2221
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 HIGHWAY 280 EAST
Second Line	:	SUITE 212
City	:	BIRMINGHAM
State	:	AL
Zip	:	35223
Country	:	US
Telephone Number	:	205-879-2221
Fax Number	:

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

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	07/20/2010

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