Individual
ADAM GEORGE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2637 MIDPOINT DR STE B, FORT COLLINS, CO 80525-4408
(970) 488-1666
(970) 472-9381
Mailing address
2637 MIDPOINT DR STE B, FORT COLLINS, CO 80525-4408
(970) 488-1666
(970) 472-9381
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
49069
CO
208M00000X
Hospitalist Physician
Primary
49069
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90970730
—
CO
01
—
P01020620
MEDICARE RR
CO
Enumeration date
05/31/2006
Last updated
11/04/2019
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