Jennewine, Paul Russell

Jennewine, Paul Russell is an sole proprietor health care provider with primary practice located at 200 N Breiel Blvd , Middletown OH 45042-3808. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Jennewine, Paul Russell can be contacted via phone (513) 424-2535.

Contact Information

Primary practice address
200 N Breiel Blvd Middletown OH 45042-3808
Fax: (513) 424-0363
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 35.072062 Ohio

Profile Details

NPI number 1790765725
LBN Legal business name Jennewine, Paul Russell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 17th, 2006
Last updated Nov 18th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790765725 NPPES
Ohio MEDICAID 2076962

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