Organization
CT AT MIDTOWN
Active
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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