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Individual

DR. ANNETTE RAQUEL NATHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
100 MEDICAL CENTER WAY, SPRINGFIELD REGIONAL MEDICAL CENTER, SPRINGFIELD, OH 45505
(937) 523-1401
(937) 523-1950
Mailing address
2699 KILKENNY CT, SPRINGFIELD, OH 45503-1164
(937) 390-0971

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
35.064717
OH
207P00000X
Emergency Medicine Physician
Primary
3564717
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000017028
ANTHEM
OH
05
0924914
OH
Enumeration date
04/12/2006
Last updated
09/06/2013
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