Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 9120 | TN |
NPI | 1093932428 |
---|---|
Provider Name | Dr. Marek Adamiak |
First Address | Brentwood, TN 37027-2903 |
Second Address | Brentwood, TN 37027-2903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 18/08/2010 |