Provider Demographics
NPI:1366512956
Name:SHAFRAN, ADAM KEITH (DC)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:KEITH
Last Name:SHAFRAN
Suffix:
Gender:M
Credentials:DC
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Mailing Address - Street 1:2424 DANVILLE RD SW
Mailing Address - Street 2:SUITE M
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603-4280
Mailing Address - Country:US
Mailing Address - Phone:256-353-4500
Mailing Address - Fax:256-301-8980
Practice Address - Street 1:1908 SLAUGHTER RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8619
Practice Address - Country:US
Practice Address - Phone:256-430-2700
Practice Address - Fax:256-430-1899
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL2178111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-36877OtherBLUE CROSS BLUE SHIELD