Basic Information
| Provider Information | |||||||||
| NPI: | 1538121678 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ADAMS | ||||||||
| FirstName: | FRANK | ||||||||
| MiddleName: | DOLAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2914 S REPUBLIC BLVD | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436151912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195318808 | ||||||||
| FaxNumber: | 4195319342 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 N SAWYER RD | ||||||||
| Address2: | |||||||||
| City: | KENDALLVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 467552568 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2603478142 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2006 | ||||||||
| LastUpdateDate: | 11/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 01064434A | IN | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 4377323 | 05 | MI | MEDICAID | 0506700132 | 01 | MI | BCBS | OTHER |