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General NPI Number Information
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NPI Number | 1811709660
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Entity Type | Individual
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Provider Name | AMANDA DONAHUE
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Gender | Female
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 10506 MONTGOMERY RD STE 209
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City | MONTGOMERY
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State | OH
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Zip | 45242-4400
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Country | US
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Telephone | 800-225-0953
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Fax |
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Provider Business Mailing Address
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Address Line | 5495 WINDRIDGE CT
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City | COLUMBIA TOWNSHIP
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State | OH
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Zip | 45243-2968
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Country | US
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Telephone | 513-317-0811
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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