Organization
THERAN ADAMSON, MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERAN ADAMSON MD (OWNER)
(208) 765-5922
Entity
Organization
Contact information
Practice address
914 W IRONWOOD DR, STE 102, COEUR D ALENE, ID 83814-4927
(208) 765-5922
Mailing address
914 W IRONWOOD DR, STE 102, COEUR D ALENE, ID 83814-4927
(208) 765-5922
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-12662
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M-12662
ID LICENSE
ID
Enumeration date
01/25/2017
Last updated
01/25/2017
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