Provider Demographics
NPI:1568662559
Name:ADAM, CLIFFORD CLAUDE (MD)
Entity type:Individual
Prefix:MR
First Name:CLIFFORD
Middle Name:CLAUDE
Last Name:ADAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 LORI LN
Mailing Address - Street 2:
Mailing Address - City:CARRABELLE
Mailing Address - State:FL
Mailing Address - Zip Code:32322-3252
Mailing Address - Country:US
Mailing Address - Phone:850-697-1217
Mailing Address - Fax:850-697-1213
Practice Address - Street 1:360 LORI LN
Practice Address - Street 2:
Practice Address - City:CARRABELLE
Practice Address - State:FL
Practice Address - Zip Code:32322-3252
Practice Address - Country:US
Practice Address - Phone:850-697-1217
Practice Address - Fax:850-697-1213
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN240208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice