Adams, Charles Pulliam

Adams, Charles Pulliam is an sole proprietor health care provider with primary practice located at 1034 Riverside Ave , Jacksonville FL 32204-4123. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Adams, Charles Pulliam can be contacted via phone (904) 354-2114.

Contact Information

Primary practice address
1034 Riverside Ave Jacksonville FL 32204-4123
Phone: (904) 354-2114
Fax: (904) 354-2122
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X ME0045165 Florida

Profile Details

NPI number 1710917950
LBN Legal business name Adams, Charles Pulliam
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 4th, 2006
Last updated Jul 21st, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710917950 NPPES
Florida Other 15929 BCBS
Florida MEDICAID 00963608A BCBS
Florida MEDICAID 041611800 BCBS

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