Individual
MICHAEL MAX ADAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1055 N 500 W STE 112, PROVO, UT 84604-3305
(801) 812-4624
(801) 812-4699
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
11685099-1205
UT
2085R0204X
Vascular & Interventional Radiology Physician
2019009760
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2014
Last updated
04/20/2026
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