Individual
DR. AMY DAWN TITUS
Active
Individual
DR. AMY DAWN TITUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5246
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000238954
ANTHEM
OH
05
—
2327986
—
OH
01
—
341194090027
CARE SOURCE
OH
Enumeration date
08/28/2006
Last updated
09/05/2007
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