Healthcare Provider Details

I. General information

NPI: 1740270644
Provider Name (Legal Business Name): WAYNE ARTHUR LIPPERT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2005
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 Number35.031837
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: