Provider Demographics
NPI:1891857512
Name:ADAMS, NATHAN BRADLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:BRADLEY
Last Name:ADAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2330 DESOTO ST
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-7570
Mailing Address - Country:US
Mailing Address - Phone:208-523-1100
Mailing Address - Fax:208-523-1317
Practice Address - Street 1:2330 DESOTO ST
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-7570
Practice Address - Country:US
Practice Address - Phone:208-523-1100
Practice Address - Fax:208-523-1317
Is Sole Proprietor?:No
Enumeration Date:2006-12-16
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDM-11486207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology