Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 16322 | NE |
NPI | 1073707949 |
---|---|
Provider Name | Charles R Adams |
First Address | Norfolk, NE 68701-3666 |
Second Address | Norfolk, NE 68701-3666 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2007 |
Last Update Date | 21/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B67884 | (02) | NE |