Provider Demographics
NPI:1003871047
Name:DENNEY, AMANDA M (MD)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:M
Last Name:DENNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:M
Other - Last Name:QUEEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4440 RED BANK RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-2177
Mailing Address - Country:US
Mailing Address - Phone:513-272-0313
Mailing Address - Fax:513-272-0316
Practice Address - Street 1:4440 RED BANK RD
Practice Address - Street 2:SUITE 210
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-2177
Practice Address - Country:US
Practice Address - Phone:513-272-0313
Practice Address - Fax:513-272-0316
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-083163207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2566281Medicaid
OH2566281Medicaid
OHDE4156523Medicare PIN
OHDE4156523Medicare PIN
000000604530OtherANTHEM PIN