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Organization
MICHAEL D. ADAMS, M.D., P.C.
Active
Organization
MICHAEL D. ADAMS, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKKI OLDHAM (OPERATIONS SUPERVISOR)
(435) 755-6061
Entity
Organization
Contact information
Practice address
75 YELLOW CREEK RD, SUITE 102, EVANSTON, WY 82930-5235
(307) 789-8290
(307) 789-8290
Mailing address
75 YELLOW CREEK RD, SUITE 102, EVANSTON, WY 82930-5235
(307) 789-8290
(307) 789-8290
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4371-A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004116106
AETNA
—
01
—
02902001
BLUECROSS/BLUESHIELD
WY
01
—
080014492
RAILROAD MEDICARE
—
05
—
103977600
—
WY
01
—
53D0977203
CLIA
WY
01
—
C12604
UPIN
—
Enumeration date
01/29/2008
Last updated
10/25/2011
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