Healthcare Provider Details

I. General information

NPI: 1346467735
Provider Name (Legal Business Name): WAYNE A LIPPERT MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 MONTGOMERY RD STE 311
MONTGOMERY OH
45242-3268
US

IV. Provider business mailing address

7630 GIVEN RD
CINCINNATI OH
45243-1510
US

V. Phone/Fax

Practice location:
  • Phone: 513-381-1400
  • Fax: 513-241-4228
Mailing address:
  • Phone: 513-381-1400
  • Fax: 513-241-4228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number35038137
License Number StateOH

VIII. Authorized Official

Name: DR. WAYNE ARTHUR LIPPERT
Title or Position: CEO
Credential: MD
Phone: 513-381-1400