Individual
PAUL RUSSELL JENNEWINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 N BREIEL BLVD, MIDDLETOWN, OH 45042-3808
(513) 424-2535
(513) 424-0363
Mailing address
200 N BREIEL BLVD, MIDDLETOWN, OH 45042-3808
(513) 424-2535
(513) 424-0363
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35.072062
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2076962
—
OH
Enumeration date
01/17/2006
Last updated
11/18/2014
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