Basic Information
Provider Information
NPI: 1013234327
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WILLIAMS
FirstName: ADAM
MiddleName: DANIEL
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10700 E GEDDES AVE STE 200
Address2:  
City: ENGLEWOOD
State: CO
PostalCode: 801123861
CountryCode: US
TelephoneNumber: 3037619190
FaxNumber: 7208744462
Practice Location
Address1: 10700 E GEDDES AVE STE 200
Address2:  
City: ENGLEWOOD
State: CO
PostalCode: 801123861
CountryCode: US
TelephoneNumber: 3037619190
FaxNumber: 7208744462
Other Information
ProviderEnumerationDate: 04/26/2010
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X29975NEN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202XMD19074HIN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202X04-39877KSN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202XDR.0056050COY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
101323432705CO MEDICAID
KA324909401KSMEDICARE PINOTHER
11125710301KSMEDICARE PINOTHER


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