Provider Demographics
NPI:1649281296
Name:ADAMO, MICHAEL PAUL (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PAUL
Last Name:ADAMO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:800 8TH AVE STE 432
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-2618
Mailing Address - Country:US
Mailing Address - Phone:817-923-2677
Mailing Address - Fax:817-923-2690
Practice Address - Street 1:800 8TH AVE STE 432
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2618
Practice Address - Country:US
Practice Address - Phone:817-923-2677
Practice Address - Fax:817-923-2690
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6377207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098401502Medicaid
TX00FR17Medicare PIN
A65284Medicare UPIN