Individual
MR. BRADLEY E ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
2205 MAIN ST, TYNDALL, SD 57066-2324
(605) 464-0545
Mailing address
PO BOX 372, TYNDALL, SD 57066-0372
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1185
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06154
BLUE CROSS BLUE SHIELD NE
NE
Enumeration date
08/11/2005
Last updated
03/07/2023
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