Provider Demographics
NPI:1316264732
Name:MACE, ADAM GEOFFREY (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:GEOFFREY
Last Name:MACE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:125 DOUGHTY ST STE 280
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403
Practice Address - Country:US
Practice Address - Phone:843-720-8317
Practice Address - Fax:843-720-8319
Is Sole Proprietor?:No
Enumeration Date:2010-04-24
Last Update Date:2021-03-08
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Provider Licenses
StateLicense IDTaxonomies
SC82351208G00000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC823513Medicaid