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Individual

JERRY W ADAMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3351 NORTH MERIDIAN STREET, STE 202, INDIANAPOLIS, IN 46208
(317) 926-8839
(317) 926-8853
Mailing address
PO BOX 88193, INDIANAPOLIS, IN 46208
(317) 926-8839
(317) 926-8853

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
01028871
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100084010C
IN
Enumeration date
10/03/2006
Last updated
07/17/2010
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