Provider Demographics
NPI:1639180946
Name:ADAMS, JULIAN C (MD)
Entity Type:Individual
Prefix:
First Name:JULIAN
Middle Name:C
Last Name:ADAMS
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:PO BOX 1488
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29202-1488
Mailing Address - Country:US
Mailing Address - Phone:803-254-6391
Mailing Address - Fax:803-799-0682
Practice Address - Street 1:1333 TAYLOR ST
Practice Address - Street 2:SUITE 1-C
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2923
Practice Address - Country:US
Practice Address - Phone:803-254-6391
Practice Address - Fax:803-799-0682
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC47742084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC047746Medicaid
SC047746Medicaid