Provider Demographics
NPI:1093991754
Name:ADAMS, MARY BRYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:BRYAN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 MEDICAL CENTER PARKWAY
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129
Mailing Address - Country:US
Mailing Address - Phone:615-907-2040
Mailing Address - Fax:615-907-2827
Practice Address - Street 1:1800 MEDICAL CENTER PKWY STE 350
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2586
Practice Address - Country:US
Practice Address - Phone:615-907-2040
Practice Address - Fax:615-907-2827
Is Sole Proprietor?:No
Enumeration Date:2008-01-12
Last Update Date:2017-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL29866207V00000X
TN51634207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL116414Medicaid
MS05030345Medicaid
MS05030345Medicaid
MS512I160061Medicare PIN