Individual
VAN LEE ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
204 MALLOY STREET, SUITE A, GOLDSBORO, NC 27534
(919) 751-7665
Mailing address
204 MALLOY ST STE A, GOLDSBORO, NC 27534-4477
(919) 751-7665
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2010-02058
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000287236
OHIO MEDICAID UNISON
OH
01
—
2969588
OHIO MEDICAID MOLINA
OH
05
—
2969588
—
OH
01
—
310917085215
OHIO MEDICAID CARESOURCE
OH
05
—
3810015431
—
WV
01
—
P00767040
RAILROAD MEDICARE
—
Enumeration date
05/18/2007
Last updated
07/17/2013
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