Organization
BRENDA J SICKLE SANTANELLO MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA M BURK (PRACTICE ADMINISTRATOR)
(614) 505-7508
Entity
Organization
Contact information
Practice address
8100 RAVINES EDGE CT, SUITE 100, COLUMBUS, OH 43235
(614) 505-7510
(614) 505-7512
Mailing address
8100 RAVINES EDGE CT, SUITE 100, COLUMBUS, OH 43235
(614) 505-7510
(614) 505-7512
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35050732
OH
174400000X
Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2251405
—
OH
Enumeration date
12/14/2006
Last updated
02/02/2011
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