Provider Demographics
NPI:1093104887
Name:WHITTINGTON, ADAM P (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:P
Last Name:WHITTINGTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8558 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-7032
Mailing Address - Country:US
Mailing Address - Phone:219-392-7084
Mailing Address - Fax:219-703-6854
Practice Address - Street 1:800 MACARTHUR BLVD STE 6
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2917
Practice Address - Country:US
Practice Address - Phone:219-703-2417
Practice Address - Fax:219-703-6947
Is Sole Proprietor?:No
Enumeration Date:2015-01-15
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI70584207N00000X
IN01086988A207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100091848Medicaid
IN300058859Medicaid