Individual
MR. MICHAEL ADAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1168 W MARTINTOWN RD, NORTH AUGUSTA, SC 29841-2046
(803) 202-0053
(803) 202-0018
Mailing address
3587 EVANS TO LOCKS RD, MARTINEZ, GA 30907-4909
(706) 869-1024
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004142
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0137PA
—
SC
05
—
124275211A
—
GA
01
—
P00688379
RAIL ROAD MEDICARE
SC
Enumeration date
08/30/2006
Last updated
07/20/2010
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