Individual
BETH J ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
13111 N PORT WASHINGTON RD, MEQUON, WI 53097-2416
(414) 290-6720
(414) 290-6755
Mailing address
111 E WISCONSIN AVE, SUITE 2000, MILWAUKEE, WI 53202-4815
(414) 290-6720
(414) 290-6755
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3174-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801237540
—
WI
Enumeration date
07/10/2013
Last updated
10/14/2013
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