Basic Information
Provider Information
NPI: 1245645647
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANK
FirstName: ADAM
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 936857
Address2:  
City: ATLANTA
State: GA
PostalCode: 311936857
CountryCode: US
TelephoneNumber: 9106677000
FaxNumber: 9108155698
Practice Location
Address1: 2131 S 17TH ST
Address2:  
City: WILMINGTON
State: NC
PostalCode: 284017407
CountryCode: US
TelephoneNumber: 9108155830
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/24/2014
LastUpdateDate: 05/27/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/27/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X37043SCN Allopathic & Osteopathic PhysiciansHospitalist 
208M00000X2019-01086NCY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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