Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 4560 | AZ |
N | 207PE0004X | Emergency Medical Services | 4560 | AZ |
N | 207PP0204X | Pediatric Emergency Physician | 4560 | AZ |
NPI | 1558465021 |
---|---|
Provider Name | Ronald L Mcadam |
First Address | Safford, AZ 85546 |
Second Address | Safford, AZ 85546 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2006 |
Last Update Date | 05/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000378676 | BCBS - MARY STREET (01) | IN |
000000380186 | BCBS - GATEWAY (01) | IL |
200800230 | (05) | IN |
I47252 | (02) | IN |