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Individual

AMANDA S. COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
8100 RAVINES EDGE CT STE 100, COLUMBUS, OH 43235-5426
(614) 488-5090
(614) 845-5216
Mailing address
8100 RAVINES EDGE CT STE 100, COLUMBUS, OH 43235-5426
(614) 488-5090
(614) 845-5216

Taxonomy

Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
35.090294
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00418673
RR MEDICARE
OH
Enumeration date
11/15/2006
Last updated
03/30/2021
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