Provider Demographics
NPI:1093931313
Name:ADAMS, MICHELLE CHRISTY (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CHRISTY
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:MARIE
Other - Last Name:CHRISTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5850 JAMILA RIVER DR
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-6676
Mailing Address - Country:US
Mailing Address - Phone:479-790-3070
Mailing Address - Fax:
Practice Address - Street 1:14239 NIGHTHAWK TER
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-6352
Practice Address - Country:US
Practice Address - Phone:479-790-3070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1121382085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology