Healthcare Provider Details

I. General information

NPI: 1912369588
Provider Name (Legal Business Name): ANNA VALENTINE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

IV. Provider business mailing address

1861 DEXTER AVE
CINCINNATI OH
45206-1459
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-4411
  • Fax: 614-722-6132
Mailing address:
  • Phone: 513-470-3999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number57.028426
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberDR.0062285
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: