Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | M12007 | ID |
NPI | 1093933830 |
---|---|
Provider Name | Robert F Adams |
First Address | Meridian, ID 83642-6351 |
Second Address | Meridian, ID 83642-6351 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 18/04/2017 |