Individual
GERALD MELVILLE PENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PHD
Contact information
Practice address
650 SHAWAN FALLS DR, DUBLIN, OH 43017-2100
(614) 764-1711
(614) 889-2652
Mailing address
650 SHAWAN FALLS DR, DUBLIN, OH 43017-2100
(614) 764-1711
(614) 889-2652
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
35027499
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1351
RR MEDICARE GRP ID
OH
Enumeration date
12/13/2005
Last updated
03/25/2008
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