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General NPI Number Information
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NPI Number | 1194103044
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Entity Type | Individual
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Provider Name | RAJEANA MICHELE CONWAY M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/12/2015
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 1775 ALYSHEBA WAY STE 201
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City | LEXINGTON
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State | KY
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Zip | 40509-2381
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Country | US
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Telephone | 859-278-5007
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Fax |
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Provider Business Mailing Address
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Address Line | 2139 AUBURN AVE
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City | CINCINNATI
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State | OH
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Zip | 45219-2906
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Country | US
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Telephone | 513-585-0855
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 51206
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License Number State | KY
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