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DENNIS ILOZULIKE ENEANYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2100 W GIRARD AVE, PHILA, PA 19130-1400
(215) 685-0800
(215) 685-0846
Mailing address
PO BOX 820933, PHILA, PA 19182-0933
(215) 926-9010
(215) 226-8286

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD041821L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001278733
PA
01
0547376000
INDEPENDENCE BLUE CROSS
PA
01
1119230
KEYSTONE MERCY HEALTH
PA
01
1595
BRAVO HEALTH
PA
01
711224
HIGHMARK BLUE SHIELD
PA
01
P00037860
RAILROAD MEDICARE
PA
Enumeration date
12/15/2005
Last updated
07/18/2011
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