Provider Demographics
NPI:1124074331
Name:LOURIE, ADAM N (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:N
Last Name:LOURIE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:55 WHITCHER ST NE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1155
Mailing Address - Country:US
Mailing Address - Phone:770-424-6893
Mailing Address - Fax:770-528-9938
Practice Address - Street 1:1700 HOSPITAL SOUTH DR
Practice Address - Street 2:SUITE 409
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-6810
Practice Address - Country:US
Practice Address - Phone:770-424-6893
Practice Address - Fax:770-528-9938
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2014-02-13
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Provider Licenses
StateLicense IDTaxonomies
GA039160207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000796177YMedicaid
GA000796177UMedicaid
GA000796177WMedicaid
GA000796177VMedicaid
GA000796177XMedicaid
GA000796177YMedicaid
GA000796177XMedicaid