Provider Demographics
NPI:1689991200
Name:MCADAMS, SEAN BRADY (MD)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:BRADY
Last Name:MCADAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SEAN
Other - Middle Name:B
Other - Last Name:MCADAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MEDICAL DOCTOR
Mailing Address - Street 1:720 S VANBUREN STREET
Mailing Address - Street 2:SUITE 301
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301
Mailing Address - Country:US
Mailing Address - Phone:920-433-9400
Mailing Address - Fax:920-433-9409
Practice Address - Street 1:720 S VANBUREN STREET
Practice Address - Street 2:SUITE 301
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301
Practice Address - Country:US
Practice Address - Phone:920-433-9400
Practice Address - Fax:920-433-9409
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI67474-20208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIK400398414OtherMEDICARE
WI100067894Medicaid