Provider Demographics
NPI:1306086137
Name:WADAMS, HEATHER DIANE (MD)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:DIANE
Last Name:WADAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-3567
Mailing Address - Country:US
Mailing Address - Phone:216-444-5437
Mailing Address - Fax:402-955-8738
Practice Address - Street 1:CLEVELAND CLINIC 9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-3567
Practice Address - Country:US
Practice Address - Phone:216-444-5437
Practice Address - Fax:216-636-6761
Is Sole Proprietor?:No
Enumeration Date:2009-03-06
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE336832080P0205X
MN57135208000000X
OH35.1511482080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN370004963Medicare PIN