Healthcare Provider Details

I. General information

NPI: 1447286232
Provider Name (Legal Business Name): DAWN M KOTOWSKI-MANFROY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 09/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7810 5 MILE RD
CINCINNATI OH
45230-2356
US

IV. Provider business mailing address

4685 FOREST AVE STE C
CINCINNATI OH
45212-3359
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-7000
  • Fax: 513-246-2876
Mailing address:
  • Phone: 513-246-7796
  • Fax: 513-852-8525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.077313
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: