Individual
DR. MICHAEL DEAN ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
75 YELLOW CREEK RD, SUITE 102, EVANSTON, WY 82930-5235
(307) 789-8290
(307) 789-8975
Mailing address
75 YELLOW CREEK RD, SUITE 102, EVANSTON, WY 82930-5235
(307) 789-8290
(307) 789-8975
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
181920-8905
UT
207Q00000X
Family Medicine Physician
Primary
4371-A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004116106
AETNA
—
01
—
02902001
BLUECROSS/BLUESHIELD CLIN
WY
01
—
080014492
RAILROAD MEDICARE
—
05
—
103977600
—
WY
01
—
53D0977203
CLIA NUMBER
WY
01
—
C12604
UPIN
—
Enumeration date
06/30/2005
Last updated
06/13/2019
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