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Individual

BENEDICTA G ENRILE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
555 S 18TH ST, COLUMBUS, OH 43205-2654
(614) 722-2438
(614) 722-4966
Mailing address
555 S 18TH ST, COLUMBUS, OH 43205-2654
(614) 722-2438
(614) 722-4966

Taxonomy

Speciality
Code
Description
License number
State
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
35034843
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0105149000
WV
05
0252524
OH
05
64789043
KY
Enumeration date
08/11/2005
Last updated
09/24/2008
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