Wynn W Adam, MD
Individual provider Active NPI Diagnostic Radiology Physician · Kettering, OH
NPI 1982653796 · NPPES record last updated Nov 15, 2010
Key facts
- NPI
- 1982653796
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 35042525 (OH)
- Practice address
- 3535 Southern Blvd
Kettering, OH 45429-1221 - Phone
- (937) 296-7202
- NPI assigned
- May 9, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kettering Radiologist Imaging Center | Diagnostic Radiology | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 35042525 | OH | Yes |
Addresses
Primary practice location
3535 Southern Blvd
Kettering, OH 45429-1221
Mailing address
PO Box 713083
Columbus, OH 43271-3083
Phone (614) 430-5707
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0675434 | Medicaid | OH |
Other providers in Kettering, OH
- 360-Wellness Center
- Emily Nichole Abner
- Renny George Abraham
- Accelerated Rehabilitation Centers LTD
- Rebekah Ruth Adams
- Robert David Nathan Adams
- Stephen Adams
- Tyler Nicholas Adams
- Heather Sue Adaway
All providers in Kettering, OH · Diagnostic Radiology Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.