Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 17698 | NE |
NPI | 1003824582 |
---|---|
Provider Name | Michael A Adams |
First Address | Norfolk, NE 68701-4457 |
Second Address | Norfolk, NE 68701-4457 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 16/08/2007 |