Provider Demographics
NPI:1114772837
Name:ASDPM LLC
Entity type:Organization
Organization Name:ASDPM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:LUTTER
Authorized Official - Last Name:SEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:937-545-2897
Mailing Address - Street 1:1381 NORWELL DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-3956
Mailing Address - Country:US
Mailing Address - Phone:937-545-2897
Mailing Address - Fax:614-864-9709
Practice Address - Street 1:3525 OLENTANGY RIVER RD STE 6300
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3937
Practice Address - Country:US
Practice Address - Phone:937-545-2897
Practice Address - Fax:614-566-2007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-18
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty