Basic Information
Provider Information
NPI: 1407858350
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADAMS
FirstName: GEORGE
MiddleName: W
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2002 MEDICAL PKWY
Address2: SUITE 235
City: ANNAPOLIS
State: MD
PostalCode: 214013046
CountryCode: US
TelephoneNumber: 4102662770
FaxNumber: 4108416251
Practice Location
Address1: 2002 MEDICAL PKWY
Address2: SUITE 235
City: ANNAPOLIS
State: MD
PostalCode: 214013046
CountryCode: US
TelephoneNumber: 4102662770
FaxNumber: 4108416251
Other Information
ProviderEnumerationDate: 08/11/2005
LastUpdateDate: 11/13/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202XD0034536MDY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202X27352NCN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
30001435601MDTRAVELERS RR MEDICAREOTHER
1069001301MDBCBSOTHER
44241150005MD MEDICAID
831707101MDAETNA PPOOTHER
262259301MDAETNA HMO/POSOTHER
725C01MDAAD SHIPLEYSOTHER
N53801MDAAD AA COUNTYOTHER
A1001MDAAD PG COUNTYOTHER


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