Provider Demographics
NPI:1538519806
Name:LINK, ADAM C (DO)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:C
Last Name:LINK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 BENEDICT AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-2715
Mailing Address - Country:US
Mailing Address - Phone:419-668-1101
Mailing Address - Fax:419-668-1191
Practice Address - Street 1:2114 STATE ROUTE 113 E
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:OH
Practice Address - Zip Code:44846-9496
Practice Address - Country:US
Practice Address - Phone:419-499-7600
Practice Address - Fax:419-499-7300
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-17
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.012999207Q00000X
OH58.007422207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0250104Medicaid