Provider Demographics
NPI:1528061819
Name:ADAMS, TODD MICHAEL (DPM)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:MICHAEL
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4357 FERGUSON DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-1760
Mailing Address - Country:US
Mailing Address - Phone:513-474-4450
Mailing Address - Fax:513-474-6387
Practice Address - Street 1:4357 FERGUSON DR
Practice Address - Street 2:SUITE 150
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-1760
Practice Address - Country:US
Practice Address - Phone:513-474-4450
Practice Address - Fax:513-474-6387
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003373213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH27-01864OtherUHC
OH2565399Medicaid
OH2570810Medicaid
P00240899OtherRR MEDICARE
OH000000373109OtherANTHEM
OH2570810Medicaid