Provider Demographics
NPI:1235138827
Name:FALL, ADAM (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:FALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5751 UPTAIN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-4010
Mailing Address - Country:US
Mailing Address - Phone:423-894-5466
Mailing Address - Fax:423-424-3690
Practice Address - Street 1:2800 WESTSIDE DR NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-3501
Practice Address - Country:US
Practice Address - Phone:423-339-4216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35125208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4110561OtherBLUE CROSS BLUE SHIELD
TNP00204781OtherRR MEDICARE
TN3862267Medicaid
TN3862267Medicare PIN
TNG07385Medicare UPIN