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Organization

CT AT MIDTOWN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KAREN E AMAYA (SENIOR DIRECTOR CORPORATE ADMIN)
(513) 924-5174
Entity
Organization

Contact information

Practice address
5400 KENNEDY AVE, CINCINNATI, OH 45213-2664
(513) 281-3400
(513) 527-2275
Mailing address
5400 KENNEDY AVE, CINCINNATI, OH 45213-2664
(513) 281-3400
(513) 527-2275

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0613IC
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000076292
ANTHEM PIN
OH
05
2141239
OH
05
86000452
KY
Enumeration date
10/28/2005
Last updated
12/11/2012
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