Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 29421 | WV |
NPI | 1033597232 |
---|---|
Provider Name | Elliot Mcnamara Adams |
First Address | Charleston, WV 25304-1227 |
Second Address | Charleston, WV 25304-1227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2015 |
Last Update Date | 15/07/2021 |