Provider Demographics
NPI:1952361495
Name:BURRELL, ADAM W (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:W
Last Name:BURRELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:121 RIVERVIEW ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734
Mailing Address - Country:US
Mailing Address - Phone:828-349-6660
Mailing Address - Fax:828-349-6664
Practice Address - Street 1:121 RIVERVIEW ST
Practice Address - Street 2:SUITE B
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734
Practice Address - Country:US
Practice Address - Phone:828-349-6660
Practice Address - Fax:828-349-6664
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCNC9900445207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89016AYMedicaid
NC8912063Medicaid
NC89016AYMedicaid
2274452AMedicare ID - Type Unspecified