Healthcare Provider Details

I. General information

NPI: 1639355258
Provider Name (Legal Business Name): AMANDA MICHELLE MCALEER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 06/17/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 W MAIN ST
SHELBY OH
44875-1490
US

IV. Provider business mailing address

24 MORRIS RD STE C
SHELBY OH
44875-1170
US

V. Phone/Fax

Practice location:
  • Phone: 419-342-2900
  • Fax:
Mailing address:
  • Phone: 419-342-2900
  • Fax: 419-342-2902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberAR2812750-RM-74
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35.123844
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: