Individual
ADAM MATTHEW WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,PH.D.
Contact information
Practice address
3551 ROGER BROOKE DR, DEPARTMENT OF NEUROLOGY, FORT SAM HOUSTON, TX 78234
(210) 916-2203
Mailing address
3551 ROGER BROOKE DR DEPT OF, FORT SAM HOUSTON, TX 78234-4504
Taxonomy
Speciality
Code
Description
License number
State
2084A2900X
Neurocritical Care Physician
Primary
R1322
TX
208D00000X
General Practice Physician
0101254958
VA
Other
Enumeration date
05/01/2012
Last updated
08/09/2019
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