Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 36872-020 | WI |
Y | 207QS0010X | Family Doctor - Sports Medicine | 50485 | MT |
NPI | 1881680510 |
---|---|
Provider Name | Dr. Erik Stuart Adams |
First Address | Bozeman, MT 59718-4400 |
Second Address | Bozeman, MT 59718-4400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 24/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1164083531 | GROUP NPI (01) | MT |
G41381 | (02) | WI |