Provider Demographics
NPI:1033393475
Name:TAM, ADELA S (MD)
Entity Type:Individual
Prefix:MS
First Name:ADELA
Middle Name:S
Last Name:TAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:933 BRADBURY DR SE, SUITE 2222
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4374
Mailing Address - Country:US
Mailing Address - Phone:505-272-3120
Mailing Address - Fax:505-272-8060
Practice Address - Street 1:6900 GONZALES RD SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87121-2401
Practice Address - Country:US
Practice Address - Phone:505-831-2534
Practice Address - Fax:505-831-4123
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-20
Last Update Date:2012-06-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2010-0527207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine