Provider Demographics
NPI:1245310853
Name:ADAMS, HEATHER MICHELLE (OD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:MICHELLE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2367 SHAWNEE CT
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-8278
Mailing Address - Country:US
Mailing Address - Phone:317-889-2049
Mailing Address - Fax:
Practice Address - Street 1:1250 E COUNTY LINE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-1004
Practice Address - Country:US
Practice Address - Phone:317-882-1527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002966152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000306615OtherBCBS
IN0419720001OtherDMERC
IN351850049101OtherCARESOURCE UPIN
INP00132350OtherRR MEDICARE
IN264310EMedicare ID - Type Unspecified
INU71549Medicare UPIN