Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 71 | SC |
NPI | 1104972058 |
---|---|
Provider Name | Dr. Milton Leverett Adams |
First Address | Guyton, GA 31312-3905 |
Second Address | Columbia, SC 29206-4920 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 03/06/2015 |