MEDICARE: DR. AMAKA ROSEMARY ODONWODO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	35.134437	OH

General Provider Information

NPI Number	:	1164804746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMAKA ROSEMARY ODONWODO MD

Provider Business Mailing Address
First Line	:	4685 FOREST AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45212-3397
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3035 HAMILTON MASON RD
Second Line	:
City	:	FAIRFIELD TOWNSHIP
State	:	OH
Zip	:	45011-5544
Country	:	US
Telephone Number	:	513-246-7000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2015
Last Update Date	:	07/19/2021

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