Basic Information
Provider Information
NPI: 1710125695
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WILLIAMS
FirstName: ADAM
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3114 BUCKINGHAM RD
Address2:  
City: DURHAM
State: NC
PostalCode: 277074506
CountryCode: US
TelephoneNumber: 3055829009
FaxNumber:  
Practice Location
Address1: 1850 NW 9TH AVE
Address2: RYDER TRAUMA T-242
City: MIAMI
State: FL
PostalCode: 33136
CountryCode: US
TelephoneNumber: 3055851280
FaxNumber: 3055856043
Other Information
ProviderEnumerationDate: 01/30/2009
LastUpdateDate: 04/27/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208G00000X2014-00931NCY Allopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery) 

No ID Information.


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