Provider Demographics
NPI:1275693517
Name:ADAMS, ROBERT MCLAIN IV (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:MCLAIN
Last Name:ADAMS
Suffix:IV
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 1:710 MILITARY CUTOFF RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-2375
Mailing Address - Country:US
Mailing Address - Phone:910-254-4818
Mailing Address - Fax:910-254-4819
Practice Address - Street 1:710 MILITARY CUTOFF RD
Practice Address - Street 2:SUITE 120
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-2375
Practice Address - Country:US
Practice Address - Phone:910-254-4818
Practice Address - Fax:910-254-4819
Is Sole Proprietor?:No
Enumeration Date:2006-12-09
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-013592084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5907819Medicaid
NC2074371Medicare PIN
H61610Medicare UPIN