Provider Demographics
NPI:1821384025
Name:WAY, AMANDA LYNN (MD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNN
Last Name:WAY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:555 S 18TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2654
Mailing Address - Country:US
Mailing Address - Phone:614-722-4075
Mailing Address - Fax:614-722-4083
Practice Address - Street 1:555 S 18TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2654
Practice Address - Country:US
Practice Address - Phone:614-722-4075
Practice Address - Fax:614-722-4083
Is Sole Proprietor?:No
Enumeration Date:2011-06-26
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35126094207WX0110X
OH35.126094207W00000X
NMRS2014-0673207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0188620Medicaid