Basic Information
| Provider Information | |||||||||
| NPI: | 1396477634 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ADAMS | ||||||||
| FirstName: | MALIKA | ||||||||
| MiddleName: | KEMET | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1459 LANEY WALKER BLVD | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309120002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067217005 | ||||||||
| FaxNumber: | 7064463546 | ||||||||
| Practice Location | |||||||||
| Address1: | 1495 LANEY WALKER BLVD | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309120002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067217005 | ||||||||
| FaxNumber: | 7064463546 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2022 | ||||||||
| LastUpdateDate: | 06/27/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 14237 | GA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.