Individual
ADONIS IMAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-5148
(706) 721-8623
(706) 721-1459
Mailing address
1120 15TH ST STE BI1056, AUGUSTA, GA 30912-0004
(706) 721-3813
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
85300
GA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/28/2016
Last updated
06/29/2020
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