Provider Demographics
NPI:1992003727
Name:ADAMS, MICHAEL WINSTON
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:WINSTON
Last Name:ADAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 E MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-3917
Mailing Address - Country:US
Mailing Address - Phone:252-332-3776
Mailing Address - Fax:252-332-3417
Practice Address - Street 1:1013 E MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-3917
Practice Address - Country:US
Practice Address - Phone:252-332-3776
Practice Address - Fax:252-332-3417
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6171183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist