Provider Demographics
NPI:1083692255
Name:ADAMS, HEATHER M (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:MARIE
Other - Last Name:BELLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12800 WARM CREEK DR
Mailing Address - Street 2:
Mailing Address - City:DEWITT
Mailing Address - State:MI
Mailing Address - Zip Code:48820-7865
Mailing Address - Country:US
Mailing Address - Phone:517-881-7887
Mailing Address - Fax:
Practice Address - Street 1:401 W GREENLAWN AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-2819
Practice Address - Country:US
Practice Address - Phone:517-975-7578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301076471208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI350C361520OtherBLUE CHOICE
MI1011958OtherHEALTH ADVANTAGE
MI350C361520OtherBLUE CARE NETWORK
MI1011958OtherMCLAREN HEALTH PLAN
MI3503311012OtherBLUE CROSS BLUE SHIELD
MI350C361520OtherCOMMUNITY BLUE PPO
MI4587483Medicaid
MI7500035OtherPHYSICIANS HEALTH PLAN
MI7570042OtherPHYS HEALTH PLAN MEDICAID
MI350C361520OtherBLUE CROSS BLUE SHIELD