Healthcare Provider Details

I. General information

NPI: 1932104106
Provider Name (Legal Business Name): KIMBERLY A WARREN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7740 WASHINGTON VILLAGE DR SUITE 100
CENTERVILLE OH
45459-4056
US

IV. Provider business mailing address

7740 WASHINGTON VILLAGE DR SUITE 100
CENTERVILLE OH
45459-4056
US

V. Phone/Fax

Practice location:
  • Phone: 937-531-7900
  • Fax: 937-531-7901
Mailing address:
  • Phone: 937-531-7900
  • Fax: 937-531-7901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number34.004139
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: