Individual
CHARLENE M CRISP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
625 AFRICA RD STE 220, WESTERVILLE, OH 43082
(614) 882-2349
(614) 882-9005
Mailing address
625 AFRICA RD STE 220, WESTERVILLE, OH 43082-9808
(614) 882-2349
(614) 882-9005
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35094122
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3054359
—
OH
05
—
7100121040
—
KY
Enumeration date
10/31/2008
Last updated
09/06/2018
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