Provider Demographics
NPI:1598705899
Name:ADAMS, LEIF MARTIN (DO)
Entity Type:Individual
Prefix:DR
First Name:LEIF
Middle Name:MARTIN
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:L
Other - Middle Name:MARTIN
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1818 HENDERSON ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2619
Mailing Address - Country:US
Mailing Address - Phone:803-758-2600
Mailing Address - Fax:803-253-8896
Practice Address - Street 1:10160 DORCHESTER RD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8527
Practice Address - Country:US
Practice Address - Phone:843-871-7900
Practice Address - Fax:843-871-8731
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC185207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC001857Medicaid
SCD178382514Medicare PIN
SC001857Medicaid