Basic Information
Provider Information
NPI: 1639358617
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADAMS
FirstName: SAMUEL
MiddleName: BRUCE
NamePrefix: DR.
NameSuffix: JR.
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5213 S ALSTON AVE
Address2:  
City: DURHAM
State: NC
PostalCode: 277134430
CountryCode: US
TelephoneNumber: 9196848111
FaxNumber:  
Practice Location
Address1: 1000 TRENT DR
Address2:  
City: DURHAM
State: NC
PostalCode: 277100001
CountryCode: US
TelephoneNumber: 9196848111
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/26/2007
LastUpdateDate: 08/17/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X2011-00832NCY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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