Healthcare Provider Details

I. General information

NPI: 1316478308
Provider Name (Legal Business Name): AMANDA WARNIMENT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA FELDMAN

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 08/18/2020
Certification Date: 08/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE # ML2008
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE # MLC5021
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4200
  • Fax:
Mailing address:
  • Phone: 513-636-4225
  • Fax: 513-636-2511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.138752
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: