MEDICARE: DR. FRANK A ADDO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	36735	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679592828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK A ADDO MD

Provider Business Mailing Address
First Line	:	5215 HOLY CROSS PKWY
Second Line	:
City	:	MISHAWAKA
State	:	IN
Zip	:	46545-1469
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2349 LAKE AVE STE 99
Second Line	:
City	:	PLYMOUTH
State	:	IN
Zip	:	46563-7837
Country	:	US
Telephone Number	:	574-948-5340
Fax Number	:	574-948-5494

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	01/13/2026

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Directions to “ DR. FRANK A ADDO MD” Practice Location

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