Individual
DR. WALTER MAX ADAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504
(928) 729-8000
Mailing address
11572 S LAKE RUN RD, SOUTH JORDAN, UT 84009-8784
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2011024400
MO
207Q00000X
Family Medicine Physician
Primary
352304-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053368860
—
MO
Enumeration date
05/27/2006
Last updated
11/26/2019
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