Provider Demographics
NPI:1952623662
Name:ADAM, WILLIAM M (RPH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:M
Last Name:ADAM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35053 ROYALTON RD
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:OH
Mailing Address - Zip Code:44044-9539
Mailing Address - Country:US
Mailing Address - Phone:440-748-2137
Mailing Address - Fax:440-748-3901
Practice Address - Street 1:35053 ROYALTON RD
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:OH
Practice Address - Zip Code:44044-9539
Practice Address - Country:US
Practice Address - Phone:440-748-2137
Practice Address - Fax:440-748-3901
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03213270183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist