Individual
DR. SHANE M ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 MED TECH PKWY, SUITE 305, JOHNSON CITY, TN 37604-4007
(423) 926-6266
(423) 926-7599
Mailing address
PO BOX 5576, JOHNSON CITY, TN 37602-5576
(423) 926-6266
(423) 926-7599
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
27416
TN
207Q00000X
Family Medicine Physician
Primary
MD27416
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154361319
—
VA
05
—
1521417
—
TN
01
—
930099587
RAILROAD MEDICARE
—
Enumeration date
06/07/2006
Last updated
03/08/2011
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