Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 21437 | SC |
NPI | 1013081678 |
---|---|
Provider Name | John B Adams II |
First Address | Beaufort, SC 29902-5423 |
Second Address | Beaufort, SC 29902-5423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 02/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2573767323 | BLUE SHIELD (01) | SC |
571087172 | AENTA (01) | SC |
571087172 | BLUE CROSS (01) | SC |
F88947 | (02) | SC |