Provider Demographics
NPI:1700882495
Name:ADAMS, JAMES W (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:W
Last Name:ADAMS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1560 BEAM AVENUE
Mailing Address - Street 2:SUITE F
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-1192
Mailing Address - Country:US
Mailing Address - Phone:651-773-0450
Mailing Address - Fax:651-773-0458
Practice Address - Street 1:1560 BEAM AVENUE
Practice Address - Street 2:SUITE F
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1192
Practice Address - Country:US
Practice Address - Phone:651-773-0450
Practice Address - Fax:651-773-0458
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2010-02-02
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Provider Licenses
StateLicense IDTaxonomies
MN23314207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNP00163243OtherRR MEDICARE
MN115990OtherUCARE
MN337M4ADOtherBLUE PLUS
MN372073000Medicaid
MN337M4ADOtherBLUE PLUS
MN110009988Medicare PIN