Healthcare Provider Details

I. General information

NPI: 1740570209
Provider Name (Legal Business Name): LEAH M WELTY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2011
Last Update Date: 10/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 JAGER CT
CINCINNATI OH
45230-4344
US

IV. Provider business mailing address

7400 JAGER CT
CINCINNATI OH
45230-4344
US

V. Phone/Fax

Practice location:
  • Phone: 513-232-8100
  • Fax: 513-232-3875
Mailing address:
  • Phone: 513-232-8100
  • Fax: 513-232-3875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.124139
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: