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Individual

AUDRA ELIZABETH ADAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
6777 W MAPLE RD, WEST BLOOMFIELD, MI 48322-3013
(248) 325-1000
Mailing address
6777 W MAPLE RD, WEST BLOOMFIELD, MI 48322-3013
(248) 325-1000

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601007027
MI
363A00000X
Physician Assistant
PA182433
OR
363A00000X
Physician Assistant
PA61260795
WA
363AS0400X
Surgical Physician Assistant
PA182433
OR
363AS0400X
Surgical Physician Assistant
PA61260795
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500734408
OR
Enumeration date
05/07/2013
Last updated
01/13/2025
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