Individual
DR. RICHARD IRENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1810 MACKENZIE DR, COLUMBUS, OH 43220-2967
(614) 538-2424
(614) 538-2418
Mailing address
974 BETHEL RD, SUITE A, COLUMBUS, OH 43214-2467
(614) 538-2424
(614) 538-2418
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
35054543
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000542268
ANTHEM
—
05
—
0660511
—
OH
Enumeration date
07/22/2005
Last updated
02/08/2008
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