Individual
JULIE SMITH FENNIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1775 DELCO PARK DR, KETTERING, OH 45420-1398
(937) 299-2339
(937) 299-3850
Mailing address
1775 DELCO PARK DR, KETTERING, OH 45420-1398
(937) 299-2339
(937) 299-3850
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
35084116
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000368948
BLUE CROSS BLUE SHIELD
—
01
—
2552133
UNITED HEALTHCARE
—
05
—
2603570
—
OH
01
—
7399698
AETNA
—
Enumeration date
10/31/2006
Last updated
07/16/2008
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