Provider Demographics
NPI:1356522528
Name:ADAMS, TODD ROBERT (RN)
Entity type:Individual
Prefix:MR
First Name:TODD
Middle Name:ROBERT
Last Name:ADAMS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 STATE ROUTE 113 E
Mailing Address - Street 2:
Mailing Address - City:BERLIN HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44814-9518
Mailing Address - Country:US
Mailing Address - Phone:419-499-4205
Mailing Address - Fax:419-499-4619
Practice Address - Street 1:5100 STATE ROUTE 113 E
Practice Address - Street 2:
Practice Address - City:BERLIN HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44814-9518
Practice Address - Country:US
Practice Address - Phone:419-499-4205
Practice Address - Fax:419-499-4619
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN309908163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse