Healthcare Provider Details

I. General information

NPI: 1003871047
Provider Name (Legal Business Name): AMANDA M. DENNEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA M. QUEEN M.D.

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 10/21/2020
Certification Date: 10/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 RED BANK RD SUITE 210
CINCINNATI OH
45227-2177
US

IV. Provider business mailing address

4440 RED BANK RD SUITE 210
CINCINNATI OH
45227-2177
US

V. Phone/Fax

Practice location:
  • Phone: 513-272-0313
  • Fax: 513-272-0316
Mailing address:
  • Phone: 513-272-0313
  • Fax: 513-272-0316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35-083163
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number35-083163
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: