# DR. HEIDI ENEJOSA RODILLO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1124194451
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 11698 | SC | Yes |

## Other

- **Enumeration date:** 11/28/2006
- **Last updated:** 01/06/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 080085988 | MEDICARE RAILROAD | SC |
| 01 | — | 11698 | SC LICENSE NUMBER | SC |
| 05 | — | 116984 | — | SC |
| 01 | — | 582366449 | TAX ID | — |
| 05 | — | PC3126 | — | SC |
| 05 | — | RHC210 | — | SC |