Provider Demographics
NPI:1619155728
Name:ADAMS, CHRISTINE L (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:L
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:L
Other - Last Name:DUGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8101 CLEARVISTA PKWY STE 185
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-5605
Mailing Address - Country:US
Mailing Address - Phone:317-621-9000
Mailing Address - Fax:317-621-9194
Practice Address - Street 1:8101 CLEARVISTA PKWY STE 185
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-5605
Practice Address - Country:US
Practice Address - Phone:317-621-9000
Practice Address - Fax:317-621-9194
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35089638208000000X
IN01070548A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2810891Medicaid
OHDU4236301OtherMEDICARE OHIO