Individual
MRS. ANYA ENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5783 WOOSTER PIKE, MEDINA, OH 44256-8816
(330) 725-0569
(330) 725-2099
Mailing address
PO BOX 75661, CLEVELAND, OH 44101-4755
(330) 725-0569
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
57007487
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9295262
MEDICARE GROUP
OH
Enumeration date
05/11/2007
Last updated
04/17/2008
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