Provider Demographics
NPI:1316902562
Name:ADAM, GEORGE A (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:A
Last Name:ADAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:220 GOODALE AVE E
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49037-2728
Mailing Address - Country:US
Mailing Address - Phone:269-964-0101
Mailing Address - Fax:269-964-9421
Practice Address - Street 1:220 GOODALE AVE E
Practice Address - Street 2:SUITE A
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49037-2728
Practice Address - Country:US
Practice Address - Phone:269-964-0101
Practice Address - Fax:269-964-9421
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIGA073501207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI352064750OtherTAX ID
MI4069460Medicaid
MIP00199549OtherRAILROAD MEDICARE
MI4069460Medicaid
MIG34381Medicare UPIN