MEDICARE: DR. RENA MICHELLE HENRIQUES M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35077838	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851324644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RENA MICHELLE HENRIQUES M.D.

Provider Business Mailing Address
First Line	:	PO BOX 7527
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43017-0727
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5150 E DUBLIN GRANVILLE RD STE 210
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43081-7023
Country	:	US
Telephone Number	:	614-788-9370
Fax Number	:	614-788-9409

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	08/19/2024

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